PRIMARY AND SECONDARY LIVER-TUMORS

The year 1993 has been rather quiet in the field of liver tumors. Some of the excitement raised by the discovery of site-specific mutations of the p53 gene in hepatocellular carcinoma is decreasing; it may just be another gene alteration occurring at a late stage of cancer development. Hepatitis C virus is becoming the most frequent etiologic factor of hepatocellular carcinoma, even in countries with high hepatitis B virus endemicity. Cirrhosis is a key step in the development of hepatocellular carcinoma in patients with viral hepatitis. Frequently, macroegenerative nodules in cirrhotic livers may be preneoplastic lesions. There were no major advances in the diagnosis and treatment of hepatocellular carcinoma. Molecular variants of alpha-fetoprotein may be the next most promising biological markers of hepatocellular carcinoma. The indications for liver transplant in the treatment of hepatocellular carcinoma have become very limited. At last, gene therapy seems to be effective for treating liver metastases (from human colon carcinoma cell lines) in mice.