title: Impact of Branched-Chain Amino Acid-Enriched Nutrient on liver Cirrhosis with Hepatocellular Carcinoma Undergoing Transcatheter Arterial Chemoembolization in Barcelona Clinic Liver Cancer Stage B: A Prospective Study.
abstract: BACKGROUND
  In decompensated liver cirrhosis, hypoalbuminemia still persists even after they have been treated with branched-chain amino acid (BCAA) granules. We prospectively evaluated whether BCAA enriched nutrient switched from BCAA granules would increase the serum albumin level, and consequently extend the survival time after hepatocellular carcinoma (HCC) treatment.
  
  
  METHODS
  This study included 77 patients treated for liver cirrhosis with HCC. After the nutritional assessment, all patients initially received BCAA granules. In patients with unchanged or decreased serum albumin levels, BCAA granules were discontinued and BCAA enriched nutrient was started. Transcatheter arterial chemembolization (TACE) for HCC were performed in those with an improved Child-Pugh score.
  
  
  RESULTS
  TACE were performed following the aggressive intervention with BCAA nutritional education in 54 of 77 (70.1%) patients. Finally, survival time was significantly extended in the TACE group (P<0.0001).
  
  
  CONCLUSIONS
  Timely aggressive nutritional intervention in Barcelona Clinic Liver Cancer stage B HCC, namely, early partial replacement with BCAA enriched nutrient may consequently improve the treatment outcome of HCC.
authors.affiliation: Department of Surgery, Tokyo Women's Medical University Medical Center East.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Shiozawa
authors.forename: Takebumi
authors.initials: T
authors.lastname: Usui
authors.forename: Kotaro
authors.initials: K
authors.lastname: Kuhara
authors.forename: Akira
authors.initials: A
authors.lastname: Tsuchiya
authors.forename: Tatsuomi
authors.initials: T
authors.lastname: Miyauchi
authors.forename: Teppei
authors.initials: T
authors.lastname: Kono
authors.forename: Shinichi
authors.initials: S
authors.lastname: Asaka
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Hajime
authors.initials: H
authors.lastname: Yokomizo
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimakawa
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Yoshimatsu
authors.forename: Takao
authors.initials: T
authors.lastname: Katsube
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Naritaka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000597:Amino Acids, Branched-Chain / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology* / Q000628:therapy*; D008113:Liver Neoplasms / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D044623:Nutrition Therapy / Q000379:methods*; D011446:Prospective Studies; D012709:Serum Albumin / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D000597:Amino Acids, Branched-Chain; D012709:Serum Albumin