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Impact of the branched‐chain amino acid to tyrosine ratio and branched‐chain amino acid granule therapy in patients with hepatocellular carcinoma: A propensity score analysis
Author(s) -
Tada Toshifumi,
Kumada Takashi,
Toyoda Hidenori,
Kiriyama Seiki,
Tanikawa Makoto,
Hisanaga Yasuhiro,
Kanamori Akira,
Kitabatake Shusuke,
Yama Tsuyoki
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12954
Subject(s) - medicine , propensity score matching , hazard ratio , hepatocellular carcinoma , confidence interval , gastroenterology , proportional hazards model , branched chain amino acid , multivariate analysis , liver function , survival analysis , oncology , amino acid , biology , biochemistry , leucine
Abstract Background and Aim It has been reported that the branched‐chain amino acid ( BCAA ) to tyrosine ratio ( BTR ) is a useful indicator of liver function and BCAA therapy is associated with a decreased incidence of hepatocellular carcinoma ( HCC ). However, there has not been sufficient research on the relationship between BTR and the effects of BCAA therapy after initial treatment of HCC . We investigated the impact of BTR and BCAA therapy on survival in patients with HCC . Methods A total of 315 patients with HCC who were treated ( n = 66) or not treated ( n = 249) with BCAA were enrolled; of these, 66 were selected from each group using propensity score matching. Survival from liver‐related mortality was analyzed. Results In patients who did not receive BCAA therapy ( n = 249), multivariate analysis for factors associated with survival indicated that low BTR (≤ 4.4) was independently associated with poor prognosis in patients with HCC (hazard ratio, 1.880; 95% confidence interval, 1.125–3.143; P = 0.016). In addition, among patients selected by propensity score matching ( n = 132), multivariate analysis indicated that BCAA therapy was independently associated with good prognosis in patients with HCC (hazard ratio, 0.524; 95% confidence interval, 0.282–0.973; P = 0.041). BTR was not significantly associated with survival. Conclusions Intervention involving BCAA therapy improved survival in patients with HCC versus untreated controls, regardless of BTR . In addition, low BTR was associated with poor prognosis in patients who did not receive BCAA therapy.