Serologic tests for antibodies to the hepatitis C virus have revealed a strong association with hepatocellular carcinoma in about 30percnt; of patients in the United States and South Africa, and more than 60percnt; in southern Europe and Japan. Transfection of an immortal mouse hepatocyte cell line with hepatitis B virus DNA leads to clones exhibiting malignant growth characteristics in soft agar and tumors in nude mice. This system may permit identification of genes that convey a tumorigenic phenotype. It is increasingly apparent that surgical resection and liver transplantation offer hope of cure for only a very small minority of patients with malignant liver tumors, and while transarterial gelfoam and lipiodol and cytotoxic embolization may cause a significant reduction in tumor volume, no positive effect on survival has been documented. Similarly, intraarterial 5-fluoro-2'-deoxy-alpha;-uridine chemotherapy for metastatic colorectal liver cancer has been conclusively shown to induce remission in about 50percnt; of cases, but demonstration of survival advantage remains elusive. These high remission rates form a sound basis for further regimens and, together with positive controlled trials of adjuvant chemotherapy in colonic cancer and hormonal therapy in hepatocellular carcinoma, they may offer brighter prospects for the future.
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