Kazuho Imanaka1, Kazuyoshi Ohkawa1, Tomohide Tatsumi2, Kazuhiro Katayama1, Atsuo Inoue3, Yasuharu Imai4, Masahide Oshita5, Sadaharu Iio6, Eiji Mita7, Hiroyuki Fukui8, Akira Yamada9, Fumihiko Nakanishi10, Masami Inada11, Yoshinori Doi12, Kunio Suzuki13, Akira Kaneko14, Shigeru Marubashi15, Yuri Ito16, Keisuke Fukui16, Ryotaro Sakamori2, Takayuki Yakushijin2, Naoki Hiramatsu2, Norio Hayashi17, Tetsuo Takehara2. 1. Department of Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. 2. Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan. 3. Department of Gastroenterology and Hepatology, Osaka General Medical Center, Osaka, Japan. 4. Department of Gastroenterology, Ikeda Municipal Hospital, Ikeda, Japan. 5. Department of Internal Medicine, Osaka Police Hospital, Osaka, Japan. 6. Department of Gastroenterology, Higashiosaka City Central Hospital, Higashiosaka, Japan. 7. Department of Gastroenterology, National Hospital Organization Osaka National Hospital, Osaka, Japan. 8. Department of Gastroenterology, Yao Municipal Hospital, Yao, Japan. 9. Department of Gastroenterology, Sumitomo Hospital, Osaka, Japan. 10. Department of Gastroenterology, National Hospital Organization Osaka Minami Medical Center, Kawachinagano, Japan. 11. Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Japan. 12. Department of Gastroenterology, Otemae Hospital, Osaka, Japan. 13. Department of Gastroenterology, Saiseikai Senri Hospital, Suita, Japan. 14. Department of Gastroenterology, NTT West Osaka Hospital, Osaka, Japan. 15. Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. 16. Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. 17. Department of Gastroenterology, Kansai Rousai Hospital, Amagasaki, Japan.
Abstract
AIM: The therapeutic efficacy of branched-chain amino acid (BCAA) when added to sorafenib has not been fully assessed in patients with advanced hepatocellular carcinoma (HCC). This multicenter study investigated whether BCAA supplementation improves prognosis in patients with advanced HCC who underwent sorafenib treatment. METHODS: This retrospective analysis included 256 patients with advanced HCC treated with sorafenib, including 55 who did and 201 who did not receive BCAA supplementation. Clinical characteristics and outcomes in relation to Child-Pugh classification were compared in the two groups. Statistical analyses of univariate, multivariate and propensity score-based procedures were used for this study. RESULTS: Assessment of 216 Child-Pugh A patients showed that median overall survival was significantly longer in patients with BCAA supplementation than in those without it (440 vs 299 days, P = 0.023). Multivariate analysis showed that BCAA supplementation (P = 0.023), low α-fetoprotein (<100 ng/mL) (P < 0.001), less progressive Barcelona Clinic Liver Cancer stage (A and B) (P = 0.007) and male sex (P = 0.018) were significant independent contributors to better overall survival. The significantly longer overall survival by BCAA supplementation was verified in the analysis using the propensity score in combination with the inverse probability of treatment weighted adjustment (P = 0.026). Assessment of the 40 Child-Pugh B patients showed no significant differences in overall survival between patients with and without BCAA supplementation. CONCLUSION: BCAA supplementation may be a valuable adjunctive therapy for improving prognosis in sorafenib-treated Child-Pugh A patients with advanced HCC.
AIM: The therapeutic efficacy of branched-chain amino acid (BCAA) when added to sorafenib has not been fully assessed in patients with advanced hepatocellular carcinoma (HCC). This multicenter study investigated whether BCAA supplementation improves prognosis in patients with advanced HCC who underwent sorafenib treatment. METHODS: This retrospective analysis included 256 patients with advanced HCC treated with sorafenib, including 55 who did and 201 who did not receive BCAA supplementation. Clinical characteristics and outcomes in relation to Child-Pugh classification were compared in the two groups. Statistical analyses of univariate, multivariate and propensity score-based procedures were used for this study. RESULTS: Assessment of 216 Child-Pugh A patients showed that median overall survival was significantly longer in patients with BCAA supplementation than in those without it (440 vs 299 days, P = 0.023). Multivariate analysis showed that BCAA supplementation (P = 0.023), low α-fetoprotein (<100 ng/mL) (P < 0.001), less progressive Barcelona Clinic Liver Cancer stage (A and B) (P = 0.007) and male sex (P = 0.018) were significant independent contributors to better overall survival. The significantly longer overall survival by BCAA supplementation was verified in the analysis using the propensity score in combination with the inverse probability of treatment weighted adjustment (P = 0.026). Assessment of the 40 Child-Pugh B patients showed no significant differences in overall survival between patients with and without BCAA supplementation. CONCLUSION:BCAA supplementation may be a valuable adjunctive therapy for improving prognosis in sorafenib-treated Child-Pugh A patients with advanced HCC.
Authors: Mahmoud Delphan; Tengda Lin; David B Liesenfeld; Johanna Nattenmüller; Jürgen T Böhm; Biljana Gigic; Nina Habermann; Lin Zielske; Petra Schrotz-King; Martin Schneider; Alexis Ulrich; Hans-Ulrich Kauczor; Cornelia M Ulrich; Jennifer Ose Journal: Metabolomics Date: 2018-01-31 Impact factor: 4.290