Oral Branched-Chain Amino Acid Granules Reduce the Incidence of Hepatocellular Carcinoma and Improve Event-Free Survival in Patients with Liver Cirrhosis

Abstract

Background: It has been reported that branched-chain amino acid (BCAA) supplementation can improve nutritional status and prevent liver-related complications in patients with decompensated cirrhosis. We investigated the effects of oral BCAA supplementation on the incidence of hepatocellular carcinoma (HCC) and liver-related events in patients with compensated and decompensated cirrhosis. Methods: We enrolled 211 patients with cirrhosis including 152 patients with Child-Pugh A cirrhosis, but no history of HCC. Of these, 56 received oral administration of 12 g/day BCAA for ≧6 months (BCAA group), and 155 were followed-up without BCAA treatment (control group). The HCC occurrence and event-free survival rates were compared between the two groups. We used a propensity score analysis to overcome selection bias of this retrospective analysis. Results: The HCC occurrence rate was significantly lower and event-free survival rate was significantly higher in the BCAA group than in the control group. Multivariate analyses showed BCAA supplementation was significantly associated with reduced incidence of HCC (hazard ratio (HR) 0.416, 95% confidence interval (CI) 0.216–0.800, p = 0.0085). BCAA supplementation also reduced the incidence of liver-related events in patients with Child-Pugh A cirrhosis, although the difference did not reach statistical significance (HR 0.585, 95% CI 0.336–1.017, p = 0.0575). Conclusions: Oral BCAA supplementation is associated with reduced incidence of HCC in patients with cirrhosis and seems to prevent liver-related events in patients with Child-Pugh A cirrhosis.

No Deterioration in Clinical Outcomes of Carbon Ion Radiotherapy for Sarcopenia Patients with Hepatocellular Carcinoma

“…This result suggested that C-ion RT could be a safe treatment for patients with sarcopenia with similar survival as for patients with non-sarcopenia. Previous report indicate that the improvement of malnutrition by the intervention of a nutrition support team and early physical therapy intervention aimed at improving skeletal muscle mass are considered to improve the survival of patients with sarcopenia (17)(18)(19). There are no fasting duration and postoperative activity restrictions in C-ion RT; thus, nutrition and physical therapy interventions could be initiated from the commencement of treatment without any interruption during C-ion RT.…”

Importance of branched-chain amino acids in patients with liver cirrhosis and advanced hepatocellular carcinoma receiving hepatic arterial infusion chemotherapy

“…Supplementation of BCAA has been reported to improve the nutritional status and prevent hepatic complications in patients with decompensated cirrhosis [13][14][15]. In addition, Hayashi et al [16] reported that BCAA supplementation was associated with a lower incidence of HCC in cirrhosis patients and appeared to prevent liver-related events in C-P class A patients. Furthermore, Harima et al [17] reported that a BCAA-enriched late evening snack improves energy metabolism and glucose tolerance in cirrhosis patients with advanced HCC undergoing HAIC.…”

Molecular Targeted Therapy for Hepatocellular Carcinoma: Bench to Bedside

“…Based on these findings, oral BCAA supplementation is now recommended in Japanese guidelines as part of the treatment of HCV-related cirrhosis [16]. Similar to the reports mentioned above, Hayaishi et al [17] showed that the event-free survival of patients with Child-Pugh A cirrhosis was better among patients given oral BCAA supplementation than in those without, although the difference did not reach statistical significance. BCAA supplementation has also been reported to be useful as an adjuvant nutritional therapy following hepatectomy and TACE, showing reduced risk of complications and better maintenance of liver function [18,19,20].…”