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Impact of Branched-Chain Amino Acid-Enriched Nutrient on liver Cirrhosis with Hepatocellular Carcinoma Undergoing Transcatheter Arterial Chemoembolization in Barcelona Clinic Liver Cancer Stage B: A Prospective Study
Department of Surgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
Background: In decompensated liver cirrhosis, hypoalbuminemia still persists even after they have been treated with branched-chain amino acid (BCAA) granules. We prospectively evaluated whether BCAA enriched nutrient switched from BCAA granules would increase the serum albumin level, and consequently extend the survival time after hepatocellular carcinoma (HCC) treatment.
Methods: This study included 77 patients treated for liver cirrhosis with HCC. After the nutritional assessment, all patients initially received BCAA granules. In patients with unchanged or decreased serum albumin levels, BCAA granules were discontinued and BCAA enriched nutrient was started. Transcatheter arterial chemembolization (TACE) for HCC were performed in those with an improved Child-Pugh score.
Results: TACE were performed following the aggressive intervention with BCAA nutritional education in 54 of 77 (70.1%) patients. Finally, survival time was significantly extended in the TACE group (P<0.0001).
Conclusion: Timely aggressive nutritional intervention in Barcelona Clinic Liver Cancer stage B HCC, namely, early partial replacement with BCAA enriched nutrient may consequently improve the treatment outcome of HCC.
J Nippon Med Sch 2016; 83: 248-256
Keywords
liver cirrhosis, hepatocellular carcinoma, transcatheter arterial chemoembolization, branched-chain amino acid, Child-Pugh score
Correspondence to
Shunichi Shiozawa, MD, Department of Surgery, Tokyo Women's Medical University Medical Center East, 2-1-10 Nisiogu, Arakawa-ku, Tokyo 116-8567, Japan
tansiosu@dnh.twmu.ac.jp
Received, June 20, 2016
Accepted, October 18, 2016
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