Short-term reductions in non-protein respiratory quotient and prealbumin can be associated with the long-term deterioration of liver function after transcatheter arterial chemoembolization in patients with hepatocellular carcinoma

Saito, Masaya; Seo, Yasushi; Yano, Yoshihiko; Miki, Akira; Yoshida, Masaru; Azuma, Takeshi

doi:10.1007/s00535-012-0535-x

Cited by 28 publications

(32 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another possible reason is that, in the majority of cases, patients with HCC frequently underwent other treatments prior to sorafenib therapy. Popular HCC therapies may cause the deterioration of liver function, potentially leading to a decreased quality of life and the occurrence of sarcopenia in patients with HCC (37). Consistent with previous studies, the presence of sarcopenia was associated with poor PS and poor liver function in the present study (38,39).…”

Section: Discussionsupporting

confidence: 90%

Prognostic significance of sarcopenia in patients with hepatocellular carcinoma undergoing sorafenib therapy

et al. 2017

View full text Add to dashboard Cite

Abstract. The present study aimed to examine the impact of sarcopenia, defined as low muscle mass on computed tomography (CT), prior to sorafenib therapy on the clinical outcomes of patients with hepatocellular carcinoma (HCC) receiving sorafenib therapy. In total, 232 patients with unresectable HCC (median age, 72 years) were analyzed, and the extent of sarcopenia was assessed using CT. Cross-sectional areas (cm 2 ) of the skeletal muscles at the third lumbar vertebra level were determined by manual outlining on the CT images. The cross-sectional areas were normalized for height [skeletal rates, progression-free survival (PFS) rates and best treatment response of the sarcopenia group were retrospectively compared with those of the non-sarcopenia group, and the factors associated with OS and PFS were examined. Sarcopenia was observed in 151 patients (65.1%). There were 165 patients with Child-Pugh A and 67 with Child-Pugh B cirrhosis. In the sarcopenia group, the median treatment duration was 66 days, whereas in the non-sarcopenia group it was 103 days (P=0.001). The median OS time was 174 days in the sarcopenia group and 454 days in the non-sarcopenia group (P<0.0001). The median PFS was 77 days in the sarcopenia group and 106 days in the non-sarcopenia group (P=0.0131). Multivariate analysis identified sarcopenia to be an independent predictor of OS (hazard ratio, 0.365; P<0.0001). The objective response rate and disease control rate in the sarcopenia group were significantly lower, compared with those in the non-sarcopenia group (P=0.0146 and P=0.0151, respectively). In conclusion, sarcopenia may be an indicator of poor clinical course in patients with HCC receiving sorafenib. IntroductionHepatocellular carcinoma (HCC) is one of the major causes of cancer-associated mortality worldwide, accounting for 5.7% of all newly diagnosed malignancies (1-5). The annual incidence rates of HCC are the highest in East Asia and Sub-Saharan Africa, where >80% of all known cases develop (1-5). Advances in treatments for HCC during the last few decades markedly improved the prognosis of the disease (1,2,4,5). However, a curative therapy such as surgical resection may be applied to a limited number (<20%) of patients with HCC (5,6). Sorafenib is a multi-kinase inhibitor that suppresses cancer growth and cell proliferation (7,8). Two pivotal randomized phase III studies, namely the Sorafenib HCC Assessment Randomized Protocol study (7)

show abstract

Section: Discussionsupporting

confidence: 90%

Prognostic significance of sarcopenia in patients with hepatocellular carcinoma undergoing sorafenib therapy

et al. 2017

View full text Add to dashboard Cite

show abstract

“…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).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2014

Self Cite

View full text Add to dashboard Cite

Objective The supplementation of oral branched-chain amino acid (BCAA) granules is known to improve energy metabolism in cirrhotic patients, but not those with hepatocellular carcinoma (HCC). We aimed to clarify whether BCAA granules improve energy metabolism in HCC patients after radiofrequency ablation (RFA). Methods We performed a prospective cohort study (UMIN000004624) involving 40 HCC patients who underwent RFA at Kobe University Hospital. Indirect calorimetry and urinary/blood biochemical examinations were performed before and seven days after RFA. Blood biochemical examinations were also conducted three months after RFA. The patients treated with and without BCAA supplementation were compared, and univariate factors were statistically examined. Results The non-protein respiratory quotient (npRQ) and albumin levels before RFA were significantly lower in the BCAA group than in the control group (p=0.024 and 0.005). The npRQ ratio (seven days after/ before RFA) was significantly higher in the BCAA group than in the control group (p=0.019). In addition, the albumin ratio (three months after/before RFA) was significantly higher in the BCAA group than in the control group (p=0.018). Conclusion Supplementation with BCAA granules improves energy metabolism in addition to the liver function after RFA. Improvements in the liver function may result in consistently adequate treatment for HCC recurrence after RFA.

show abstract

“…The long-term deterioration of liver function after TACE can originate from the progression of energy malnutrition (Saito et al 2012a). In general, the non-protein respiratory quotient (npRQ) is the main factor used to evaluate energy metabolism on the basis of indirect calorimetry (Tajika et al 2002).…”

Section: Resultsmentioning

confidence: 99%

“…In general, the non-protein respiratory quotient (npRQ) is the main factor used to evaluate energy metabolism on the basis of indirect calorimetry (Tajika et al 2002). Short-term reduction in npRQ was found to be related to long-term liver dysfunction after TACE (Saito et al 2012a). On the other hand, no background characteristic factors that could promote the development of energy malnutrition after TACE have been identified.…”

Section: Resultsmentioning

confidence: 99%

Alteration of non-protein respiratory quotient after hepatocellular carcinoma treatment can be related to des-γ-carboxy prothrombin before treatment

et al. 2012

Self Cite

View full text Add to dashboard Cite

BackgroundTranscatheter arterial chemoembolization (TACE) is an effective treatment for hepatocellular carcinoma (HCC) that would occasionally lead to energy malnutrition through therapeutic hypoxic stress. We aimed to clarify the correlation between the energy malnutrition after TACE and low tolerability for hypoxia of non-tumoral liver before TACE.FindingsWe performed a prospective cohort study involving 100 HCC patients who underwent TACE at Kobe University Hospital. Indirect calorimetry was performed before and 7 days after TACE, and non-protein respiratory quotient (npRQ) as an indicator of the energy malnutrition was measured. Blood biochemical examinations were also performed before TACE. As an indicator of hypoxic marker, des-γ-carboxy prothrombin (DCP) was measured before TACE. The correlation between npRQ ratio (7 days after/before TACE) and DCP (before TACE) was statistically examined. Spearman’s correlation coefficient test showed that npRQ ratio (Day 7/Day 0) was significantly related to DCP (Day 0) (p=0.0481, r=-0.2033). On the other hand, npRQ ratio (Day 7/Day 0) was not related to alpha fetoprotein (Day 0) (p=0.6254, r=-0.0494).ConclusionsThe npRQ reduction after TACE was related to a high value of DCP before TACE. The energy malnutrition after TACE would originate from low tolerability for hypoxia of non-tumoral liver. The HCC patients with a high value of DCP before TACE would clinically have a high risk of the energy malnutrition after TACE.

show abstract

Short-term reductions in non-protein respiratory quotient and prealbumin can be associated with the long-term deterioration of liver function after transcatheter arterial chemoembolization in patients with hepatocellular carcinoma

Abstract: Reductions in npRQ and preAlb 7 days after TACE were associated with the long-term deterioration of liver function. With our model, we were able to identify high-risk patients.

Cited by 28 publications

References 35 publications

Prognostic significance of sarcopenia in patients with hepatocellular carcinoma undergoing sorafenib therapy

Prognostic significance of sarcopenia in patients with hepatocellular carcinoma undergoing sorafenib therapy

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

Alteration of non-protein respiratory quotient after hepatocellular carcinoma treatment can be related to des-γ-carboxy prothrombin before treatment

Contact Info

Product

Resources

About