Effects of in‐hospital exercise on liver function, physical ability, and muscle mass during treatment of hepatoma in patients with chronic liver disease

Koya, Shunji; Kawaguchi, Takumi; Hashida, Ryuki; Goto, Emiko; Matsuse, Hiroo; Saito, Hiromichi; Hirota, Kaoru; R, Taira; Matsushita, Yoshiko; Imanaga, Minami; Nagamatsu, Ayu; Shirono, Tomotake; Shimose, Shigeo; Iwamoto, Hideki; Nishizaki, Takashi; Kuromatsu, Ryoko; Miura, Hiroko; Shiba, Naoto; Torimura, Takuji

doi:10.1111/hepr.12718

Cited by 62 publications

(77 citation statements)

References 45 publications

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“…Future studies of exercise and nutrition treatments on HCC and chronic liver disease are warranted since loss of skeletal muscle mass is the independent predictor of prognosis of HCC. In fact, there is some evidence showing that regular aerobic exercise decreased liver tumor development in a mice model [44], and branched-chain amino acid supplement was associated with less skeletal muscle atrophy in patients with HCC [45]. Besides, since most cases with HCC developed in patients with chronic liver disease, in which muscle volume loss and muscle strength decrease, we should evaluate the muscle mass and strength and treat with exercise and nutritional supplement not only in patients with chronic liver disease but also in those with HCC [45].…”

Section: Discussionmentioning

confidence: 99%

Association between Loss of Skeletal Muscle Mass and Mortality and Tumor Recurrence in Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Chang¹,

Chen

Wu³

et al. 2017

Liver Cancer

159

140

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Background: Hepatocellular carcinoma (HCC) has multiple prognostic factors, and there is an increase in knowledge about the body composition and physical status of patients with HCC. The present meta-analysis aimed to explore whether loss of skeletal muscle mass is associated with mortality and tumor recurrence in patients with HCC. Method: A systematic search was conducted for published literature using PubMed, Embase, and Scopus. We included cohort or case-control studies investigating patients with HCC. The primary and secondary outcomes were the associations of loss of skeletal muscle mass with overall survival and tumor recurrence, respectively, expressed by a summary hazard ratio (HR) and 95% confidence interval (CI). Result: A total of 13 studies comprising 3,111 patients were included. The summary HRs calculated by either univariate or multivariate analysis both suggested a significant association between sarcopenia and all-cause mortality (crude HR = 2.04, 95% CI: 1.74-2.38; adjusted HR = 1.95, 95% CI: 1.60-2.37). Similarly, loss of skeletal muscle mass was associated with tumor recurrence (crude HR = 1.85, 95% CI: 1.44-2.37; adjusted HR = 1.76, 95% CI: 1.27-2.45). The stratified analysis showed that treatment types and inclusion of body mass index or body weight in the Cox regression model did not modify both clinical outcomes. With an increase in cut-off values of muscle mass on computed tomography images (especially for male patients), there was an insignificant trend of stronger associations between loss of skeletal muscle mass and all-cause mortality. Conclusion: Loss of skeletal muscle mass is associated with increased all-cause mortality and tumor recurrence in patients with HCC. Further prospective studies incorporating measurements of muscle strength and physical function are warranted to see whether inclusion of both parameters better predicts the outcome than use of muscle mass only.

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Section: Discussionmentioning

confidence: 99%

Association between Loss of Skeletal Muscle Mass and Mortality and Tumor Recurrence in Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Chang¹,

Chen

Wu³

et al. 2017

Liver Cancer

159

140

View full text Add to dashboard Cite

show abstract

“…However, its mechanisms remain unclear, and there is still more room for further research in the field of adipokines and how they affect HCC [40] and nutrition. Nutritional therapies [41] or exercise [42] may be useful as an adjunctive therapy for sarcopenia. However, there are a few reports on the efficacy of branched-chain amino acid granules [43, 44] and no reports on the efficacy of exercise in HCC patients treated with sorafenib.…”

Section: Discussionmentioning

confidence: 99%

No Muscle Depletion with High Visceral Fat as a Novel Beneficial Biomarker of Sorafenib for Hepatocellular Carcinoma

et al. 2018

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Background: Sorafenib is a standard therapy for patients with advanced hepatocellular carcinoma (HCC). However, no predictive biomarkers of sorafenib efficacy have been discovered. Herein, we investigated the impact of body composition, such as skeletal muscle and visceral fat, on the prognosis of advanced HCC patients treated with sorafenib. Methods: We enrolled 100 patients with advanced HCC treated with sorafenib. Prior to receiving sorafenib therapy, skeletal muscle index (SMI) and visceral fat area (VFA) were measured using computed tomography at the third lumbar vertebra and umbilical level, respectively. Muscle depletion was defined as an SMI value < 42 cm²/m² in men and < 38 cm²/m² in women. High VFA (H-VFA) was defined as a value ≥100 cm². In addition to SMI and VFA, we also analyzed various clinical parameters as potential prognostic factors. Results: Multivariate analysis showed that having a tumor number < 7 (hazard ratio [HR] = 0.409, p < 0.001), absence of extrahepatic spread (EHS) (HR = 0.562, p < 0.001), absence of muscle depletion (HR = 0.498, p = 0.006), and H-VFA (HR = 0.556, p = 0.031) were significant factors for long-term survival. Therefore, we evaluated the prognosis of those with no muscle depletion with H-VFA. The no muscle depletion with H-VFA group showed significantly longer survival than the other group (median survival time 15.6 vs. 11.0 months, p = 0.003). Multivariate analysis showed that having a tumor number < 7 (HR = 0.454, p = 0.001), absence of EHS (HR = 0.511, p = 0.008), and no muscle depletion with H-VFA (HR = 0.454, p = 0.002) were significant predictors of survival. Conclusions: We identified no muscle depletion with H-VFA as a novel biomarker for advanced HCC patients treated with sorafenib.

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“…Koya et al [30] demonstrated that therapeutic exercise improved cardiopulmonary function evaluated by a 6-min walking test in HCC patients.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Low Muscle Mass and Low Muscle Quality Negatively Impact on Pulmonary Function in Patients Undergoing Hepatectomy for Hepatocellular Carcinoma

et al. 2017

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Background: Sarcopenia is a prognostic factor for mortality in digestive surgery. However, the correlation between preoperative cardiopulmonary function and sarcopenia in patients undergoing hepatectomy for hepatocellular carcinoma (HCC) remains unclear. Methods: The present study investigated the impact of preoperative sarcopenia on cardiopulmonary function in 402 patients who underwent first hepatectomy for HCC between April 2005 and April 2015. The quantity and quality of skeletal muscle were evaluated using psoas muscle index (PMI) and intramuscular adipose tissue content (IMAC), respectively, as determined from preoperative computed tomography imaging. Correlations between preoperative cardiopulmonary function and sarcopenic factors (PMI and IMAC) were evaluated. Results: No significant correlations were found between left ventricular ejection fraction and the two sarcopenic factors. On the other hand, preoperative vital capacity (VC) and forced expiratory volume in 1 s (FEV₁) correlated significantly with PMI (p < 0.001 each) in males and with IMAC (p < 0.001 each) in females. Moreover, VC and FEV₁ in the preoperative low PMI (p < 0.001 each) and high IMAC (p = 0.002 and p < 0.001, respectively) groups were significantly lower than in the normal group in males. In females, VC and FEV₁ were significantly lower in the preoperative high IMAC group than in the normal group (p < 0.001 each). Conclusion: Preoperative low muscle mass in males and low muscle quality in males and females were significantly associated with pulmonary dysfunction.

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Effects of in‐hospital exercise on liver function, physical ability, and muscle mass during treatment of hepatoma in patients with chronic liver disease

Cited by 62 publications

References 45 publications

Association between Loss of Skeletal Muscle Mass and Mortality and Tumor Recurrence in Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Association between Loss of Skeletal Muscle Mass and Mortality and Tumor Recurrence in Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

No Muscle Depletion with High Visceral Fat as a Novel Beneficial Biomarker of Sorafenib for Hepatocellular Carcinoma

Preoperative Low Muscle Mass and Low Muscle Quality Negatively Impact on Pulmonary Function in Patients Undergoing Hepatectomy for Hepatocellular Carcinoma

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