Effects of branched‐chain amino acids on postoperative tumor recurrence in patients undergoing curative resection for hepatocellular carcinoma: A randomized clinical trial. (8th October 2020)

• Record Type: Journal Article
• Authors: Hachiya, Hiroyuki; Aoki, Taku; Iso, Yukihiro; Shimizu, Takayuki; Tago, Kazuma; Park, Kyung Hwa; Sakuraoka, Yuhki; Shiraki, Takayuki; Mori, Shozo; Kubota, Keiichi
• Is Part Of: Journal of hepato-biliary-pancreatic sciences. Volume 27:Number 11(2020)
• Page Start: 819
• Page End: 829
• Publication Date: 2020-10-08
• Subjects: branched‐chain amino acids -- hepatocellular carcinoma -- hepatectomy -- recurrence‐free survival -- overall survival; Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 617.556
• DOI: 10.1002/jhbp.830
• Languages: English
• ISSNs: 1868-6974

Abstract

Abstract: Background/Purpose: No effective postoperative adjuvant therapies have been established for patients with hepatocellular carcinoma (HCC). The aim of this study was to investigate the effect of oral administration of branched‐chain amino acids (BCAA) on the recurrence‐free survival (RFS) after hepatic resection in HCC patients. Methods: In this randomized clinical trial, HCC patients undergoing curative resections were randomly assigned in a 1:1 ratio to the BCAA group or surgery‐alone group. The BCAA group received BCAA (Livact ® ) for up to 4 years. The primary endpoint was RFS. The secondary endpoint was overall survival (OS). Multivariate analysis was performed to detect the clinical characteristics significantly associated with RFS. Results: Between January 2010 and October 2014, 156 patients (75 in BCAA group and 81 in surgery‐alone group) were enrolled in the study. Of these, two patients were excluded from the efficacy analysis. Comparison of the survival curves by the log rank test demonstrated no significant difference in the RFS ( P = .579) or OS ( P = .268) between the BCAA and the control group. Multivariate analysis revealed that the RFS was significantly associated with age and number of tumors. A beneficial effect of BCAA on the RFS was found in patients younger than 72 years old with a HbA1c level of < 6.4%. Conclusions: Oral BCAA supplementation could not reduce the risk of recurrence after hepatic resection in HCC patients; however, the results suggested that BCAA supplementation may be beneficial for selected patients who were younger and had mildly impaired glucose tolerance. Abstract : Highlight Hachiya and colleagues conducted a single‐center, open‐label randomized clinical trial to investigate the effect of oral administration of branched‐chain amino acids on recurrence‐free survival after hepatic resection for hepatocellular carcinoma. Although the results suggested benefit in selected low‐risk patients, branched‐chain amino acids failed to reduce post‐operative recurrence of hepatocellular carcinoma.