Long-term oral administration of branched chain amino acids after curative resection of hepatocellular carcinoma: A prospective randomized trial

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Abstract
Live cirrhosis is a state of protein calorie malnutrition which may induce various complications. This study aimed to elucidate if long-term nutritional support with branched chain amino acids (BCAAs) is effective after hepatic resection for hepatocellular carcinoma (HCC). Between 2 and 3 weeks after operation, 75 patients were randomized to receive oral BCAAs (Aminoleban EN) 100 g per day for 1 year, and another 75 patients were assigned to a control group. Mean follow-up times were 35.8 months and 36.0 months respectively. Flapping tremor was less common, body-weight was greater and performance status was better in the BCAA-treated group throughout the 1-year period. BCAA treatment significantly increased red blood cell and serum albumin level in patients with Child grade B and C disease. Substantially similar effects were observed in those with major hepatic resection. Higher Fischer molar ratios were maintained in the treated group. However, there were no differences in cumulative tumour recurrence and survival rates. Long-term oral nutritional support with BCAAs after resection of HCC is beneficial in improving clinical features and laboratory data without increasing the rate of tumour recurrence, particularly in patients with advanced cirrhosis or after major hepatic resection.