title: Branched-chain amino acid treatment before transcatheter arterial chemoembolization for hepatocellular carcinoma.
abstract: OBJECTIVE
  To examine the significance of branched-chain amino acid (BCAA) treatment before transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).
  
  
  METHODS
  This study included 99 patients who underwent TACE therapy for HCC at our hospital and were followed up without treatment for at least 6 mo between January 2004 and January 2010. They were divided into 2 groups: those receiving BCAA granules (n = 40) or regular diet (n = 59, control). Data obtained were retrospectively analyzed (prior to TACE, and 1 wk, 1, 3, and 6 mo after TACE) in terms of nutritional condition and clinical laboratory parameters (serum albumin level and Child-Pugh score), both of which are determinants of hepatic functional reserve.
  
  
  RESULTS
  The BCAA group comprised 27 males and 13 females with a mean age of 69.9 ± 8.8 years. The patients of the BCAA group were classified as follows: Child-Pugh A/B/C in 22/15/3 patients, and Stage II/III/IVA HCC in 12/23/5 patients, respectively. The control group comprised 32 males and 27 females with a mean age of 73.2 ± 10.1 years. In the control group, 9 patients had chronic hepatitis, Child-Pugh A/B/C in 39/10/1 patients, and StageI/II/III/IVA HCC in 1/11/35/12 patients, respectively. Overall, both serum albumin level and Child-Pugh score improved significantly in the BCAA group as compared with the control 3 and 6 mo after TACE (P < 0.05). Further analysis was performed by the following categorization: (1) child-Pugh classification; (2) liver cirrhosis subgroup with a serum albumin level > 3.5 g/dL; and (3) epirubicin dose. A similar trend indicating a significant improvement of all variables in the BCAA group was noted (P < 0.05).
  
  
  CONCLUSIONS
  Treatment with BCAA granules in patients who have undergone TACE for HCC is considered useful to maintain their hepatic functional reserve.
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka 543-0027, Japan. h-nishikawa@osaka-med.jrc.or.jp
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nishikawa
authors.forename: Yukio
authors.initials: Y
authors.lastname: Osaki
authors.forename: Tadashi
authors.initials: T
authors.lastname: Inuzuka
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Takeda
authors.forename: Jun
authors.initials: J
authors.lastname: Nakajima
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Matsuda
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Henmi
authors.forename: Azusa
authors.initials: A
authors.lastname: Sakamoto
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Sumio
authors.initials: S
authors.lastname: Saito
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Kita
authors.forename: Toru
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000597:Amino Acids, Branched-Chain / Q000627:therapeutic use*; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D015251:Epirubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000597:Amino Acids, Branched-Chain; D000903:Antibiotics, Antineoplastic; D015251:Epirubicin