臨床外科62巻9号

2007年09月発行

特集 多発肝転移をめぐって

根治的肝切除の適応と治療成績

著者： 橋本拓哉¹ 國土典宏¹

所属機関： ¹東京大学大学院医学系研究科肝胆膵外科学

ページ範囲：P.1173 - P.1179

要旨：肝臓は悪性腫瘍の血行性転移の主な転移先の臓器の1つであり，発見時にすでに多発転移をきたしていることも稀ではない．手術以外の根治的治療法はなく，これらの転移性肝腫瘍に対して肝切除が試みられてきた．特に大腸癌肝転移に対しては，多発肝転移症例に対しても積極的に肝切除が行われており，遠隔成績を含めた様々なエビデンスが報告されている．肝切除そのものの進歩やそれに伴う安全性の向上によって技術的な切除限界はなくなりつつあるが，転移個数を含めた根治的手術の適応に関しては一定の見解が得られていない．多発肝転移の肝切除後の遠隔成績に関しては，いまだ満足できるものとは言えず，肝切除を中心に据えたうえで，化学療法併用なども含めた治療戦略を模索していく必要がある．

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