Nishikawa Hiroki, Kita Ryuichi, Kimura Toru, Ohara Yoshiaki, Takeda Haruhiko, Sakamoto Azusa, Saito Sumio, Nishijima Norihiro, Nasu Akihiro, Komekado Hideyuki, Osaki Yukio
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka 543-0027, Japan.
Int J Oncol. 2014 Sep;45(3):1082-90. doi: 10.3892/ijo.2014.2514. Epub 2014 Jun 24.
We examined whether supplementation of branched-chain amino acid (BCAA) granules in an early stage of underlying liver disease (pretreatment serum albumin levels ≥ 3.6 g/dl) can improve overall survival (OS) after therapy for hepatocellular carcinoma (HCC) using propensity score matching analysis. We compared OS between patients treated with BCAA granules and control group patients in two propensity score matched cohorts (cohort 1: pretreatment serum albumin levels ≥ 3.6 g/dl and <4.0 g/dl, 111 pairs; cohort 2: pretreatment serum albumin levels ≥ 4.0 g/dl, 61 pairs). We also performed subgroup analyses according to HCC stage. In cohort 1 patients, the OS rate in the BCAA group (median follow-up period, 2.9 years) tended to be higher compared to that in the control group (median follow-up period, 2.6 years) (1- and 3-year OS rates; 97.2 and 75.5% in the BCAA group and 87.2 and 64.5% in the control group, P=0.072), whereas in cohort 2 patients, the difference in the two groups did not reach significance in terms of OS [1- and 3-year OS rates; 83.2 and 60.7% in the BCAA group (median follow-up period, 2.3 years) and 91.8 and 66.0% in the control group (median follow-up period, 2.9 years), P=0.871]. In subgroup analyses, in cohort 1, in patients with HCC stage III or IV, the OS rate in the BCAA group (n=37) was significantly higher compared to that in the control group (n=34) (P=0.017). In other subgroup analyses, no significant difference in the two groups was found in terms of OS. In conclusion, early interventional therapies using BCAA granules may be effective in some selected HCC patients.
我们采用倾向评分匹配分析，研究了在潜在肝脏疾病早期（治疗前血清白蛋白水平≥3.6 g/dl）补充支链氨基酸（BCAA）颗粒是否能改善肝细胞癌（HCC）治疗后的总生存期（OS）。我们比较了两个倾向评分匹配队列中接受BCAA颗粒治疗的患者与对照组患者的OS（队列1：治疗前血清白蛋白水平≥3.6 g/dl且<4.0 g/dl，111对；队列2：治疗前血清白蛋白水平≥4.0 g/dl，61对）。我们还根据HCC分期进行了亚组分析。在队列1患者中，BCAA组（中位随访期2.9年）的OS率与对照组（中位随访期2.6年）相比有升高趋势（1年和3年OS率：BCAA组分别为97.2%和75.5%，对照组分别为87.2%和64.5%，P = 0.072），而在队列2患者中，两组在OS方面的差异未达到显著水平[1年和3年OS率：BCAA组（中位随访期2.3年）分别为83.2%和60.7%，对照组（中位随访期2.9年）分别为91.8%和66.0%，P = 0.871]。在亚组分析中，在队列1中，HCC III期或IV期患者中，BCAA组（n = 37）的OS率显著高于对照组（n = 34）（P = 0.017）。在其他亚组分析中，两组在OS方面未发现显著差异。总之，使用BCAA颗粒的早期介入治疗可能对某些特定的HCC患者有效。
