[TNM classification of liver cancer]

The current TNM classification of the liver was published in 1987 by UICC, which is the same as the staging system in the general Rules for the Clinical and Pathological Study of Primary Liver Cancer by the Liver Cancer Study Group of Japan (3rd Ed.) and was proposed by the Japanese TNM Committee. This was established based upon the data obtained before 1985. Thus, the current TNM classification does not always meet the latest knowledge of advanced hepatic oncology. The disease in which lesions are present both in the left and the right hepatic lobe is defined as Stage 4. Multiple liver cancers of multicentric carcinogenesis which are present in the two hepatic lobe and which are often detected recently, are stage 4 by the current TNM classification. But the postoperative prognosis of this kind of multiple liver cancer is found to be better than that of stage 4 of the advanced type, and equal to stage 3. Some proposals of reversed TNM classification of the liver, made with a small number of experienced cases have been published. However, not all of them would be convincing even with testing of a large number of cases.