Oncology

ONC: Liver Cancer (2006)

Intervention
Is there a relationship between a patient’s oral intake of BCAA and reduction in symptoms associated with resectable liver cancer?
- Conclusion
  
  Two (2) RCTs (both + quality) found that daily use of an oral BCAA supplement improved albumin levels in patients who have undergone liver resection for primary hepatocellular cancer. Meng et al. concluded that consumption of an oral BCAA supplement (16.5 g daily) for 12 weeks following surgery improved hemoglobin levels, sodium levels, and bilirubin levels in resectable liver cancer patients, as well as shortening length of hospital stay. The San-in group found that oral BCAA supplementation (11 g daily) for one year following surgery improved red cell and platelet counts, body weight, performance status, and neurological conditions.
  
  Neither Meng et al. or the San-in group noted any significant difference between study and control groups in terms of rate of cancer recurrence or survival time.
  
  Further studies are needed to determine the effect of BCAA in reduction of symptoms associated with resectable primary hepatocellular carcinoma.
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: Oral intake of BCAA and reduction in symptoms associated with resectable liver cancer
- Search Plan and Results: BCAA and Symptoms/Treatment 2005
Is there a relationship between a patient’s intake of oral granular BCAA and reduction in symptoms associated with hepatectomy for liver cancer patients with cirrhosis?
- Conclusion
  
  One (1) RCT (+ quality) concluded that a 1-year course of daily oral BCAA supplementation (14.22 g daily), following hepatectomy for liver cancer with cirrhosis inhibited liver fibrosis and possibly improved recovery of liver tissue function.
  
  Further studies are needed to determine the effects of oral BCAA supplementation in reduction of symptoms associated with hepatectomy for liver cancer complicated by cirrhosis.
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: Association of oral granular BCAA supplementation with reduction in symptoms associated with hepatectomy for liver cancer with cirrhosis
- Search Plan and Results: BCAA and Symptoms/Treatment 2005
Is there a relationship between oral BCAA supplementation and a reduction in symptoms associated with cancer in patients undergoing chemoembolization for unresectable liver cancer?
- Conclusion
  
  One (1) RCT (+ quality) found that long-term oral administration of BCAAs (11 g daily) in patients with unresectable liver cancer is beneficial in increasing serum albumin, reducing hyperbilirubinemia, reducing morbidity, reducing the incidence of ascites and peripheral edema, reducing the number of hospital readmissions, and improving hand grip strength in patients receiving trans-arterial chemoembolization for unresectable hepatocellular carcinoma.
  
  Further studies are needed to determine the effects of oral BCAA supplementation in reduction of symptoms associated with hepatectomy for liver cancer complicated by cirrhosis.
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What evidence suggests a relationship between oral BCAA supplementation and a reduction in symptoms associated with cancer in patients undergoing chemoembolization for unresectable liver cancer?
  - Detail
  - Quality Rating Summary
    For a summary of the Quality Rating results, click here.
  - Worksheets
    
    Poon, R.T.P., Yu, W.D., Fan, S.T., and Wong, J. Long-term oral branched chain amino acids in patients undergoing chemoembolization for hepatocellular carcinoma; a randomized trial. Alimentary Pharmacology and Therapeutics (2004) 19: 779-788.
- Search Plan and Results: BCAA and Symptoms/Treatment 2005