Reduction in Non-Protein Respiratory Quotient Is Related to Overall Survival after Hepatocellular Carcinoma Treatment

Abstract

BackgroundTranscatheter arterial chemoembolization (TACE) is an effective treatment for hepatocellular carcinoma (HCC) that can occasionally lead to the shortening of life expectancy. We aimed to make a new and more accurate prognostic model taking into account the course of disease after TACE.Methodology/Principal FindingsWe performed a prospective cohort study involving 100 HCC patients who underwent TACE at Kobe University Hospital. Indirect calorimetry and blood biochemical examinations were performed before and 7 days after TACE. Time-dependent and time-fixed factors associated with 1-year mortality after TACE were assessed by multivariate analyses. A predictive model of 1-year mortality was established by the combination of odds ratios of these factors. Multivariate analyses showed that the ratio of non-protein respiratory quotient (npRQ) (7 days after/before TACE) and Cancer of Liver Italian Program (CLIP) score were independent factors of 1-year mortality after TACE (p = 0.014 and 0.013, respectively). Patient-specific 1-year mortality risk scores can be calculated by summarizing the individual risk scores and looking up the patient-specific risk on the graph.ConclusionsThe short-term reduction of npRQ was a time-dependent prognostic factor associated with overall survival in HCC patients undergoing TACE. CLIP score was a time-fixed prognostic factor associated with overall survival. Using the prediction model, which consists of the combination of time-dependent (npRQ ratio) and time-fixed (CLIP score) prognostic factors, 1-year mortality risk after TACE would be better estimated by taking into account changes during the course of disease.

Liver function and energy metabolism in hepatocellular carcinoma developed in patients with hepatitis B-related cirrhosis

“…[1–4] It is still controversial whether the reduction or increase of REE is correlated with cirrhosis, [34–36] but non-protein RQ is associated with the prognosis of liver cirrhosis [37] and HCC. [38,39] Previous studies by Wu et al [40] showed that patients with malignant tumors were not in a state of high metabolism, 24% of patients with malignant tumors were in low metabolic state, 46% of patients with malignant tumors were in normal metabolic state, and 30% of patients with malignant tumors were in high metabolic state. In this study, metabolic carts were used to analyze the energy metabolism of patients in the LC and HCC groups.…”

Branched-chain Amino Acid Granules Improve the Non-protein Respiratory Quotient after Radiofrequency Ablation

“…Previous studies have shown that the supplementation of oral branched-chain amino acid (BCAA) granules improves energy metabolism in cirrhotic patients without HCC (10). In general, energy metabolism is evaluated according to the non-protein respiratory quotient (npRQ) based on indirect calorimetry (11)(12)(13). Moreover, recent studies have shown that supplementation with BCAA-enriched nutrients improves the npRQ in HCC patients after RFA (14).…”

Comparison of the prognostic validity of three simplified consciousness assessment scales with the Glasgow Coma Scale

“…This way of assessing coma scales is widely accepted and has been used before [ 8 , 12 , 23 , 29 , 30 ]. The formula proposed by de Long [ 31 ] was followed for AUC comparisons [ 28 , 32 – 35 ], with Bonferroni correction for multiple comparisons [ 36 , 37 ]. AUCs for all outcomes of interest were also calculated for a sub-group analysis, including only patients with head trauma.…”