Pre-, Peri-, and Postoperative Oral Administration of Branched-Chain Amino Acids for Primary Liver Cancer Patients for Hepatic Resection: A Systematic Review

Abstract

Pre-, peri-, and postoperative oral administration of branched-chain amino acids (BCAA) to patients with primary liver cancer (PLC) during hepatic resection (HR) remains controversial. The aim of this systematic review was to evaluate the efficacy and safety of this practice. Seven literature databases were systematically searched for randomized controlled trials (RCTs) that reported pre-, peri-, and postoperative oral administration of BCAA for PLC patients during HR. Three RCTs were included in a meta-analysis in which risk ratios (RRs) and 95% confidence intervals (95% CIs) were calculated. The 2 groups showed similar recurrence rates (RR = 1.03, 95% CI 0.78 to 1.36) and similar overall survival (RR = 0.91, 95% CI 0.71 to 1.18). Adverse events related to oral administration of BCAA were more than the control group, including nausea, vomiting, diarrhea, abdominal distension, abdominal pain, and hypertension. However, all adverse reactions disappeared after symptomatic treatment. The available evidence suggests that although pre-, peri-, and postoperative oral BCAA for patients with PLC is safe, it is of questionable clinical value. More RCTs are warranted to explore this question definitively.

ACKNOWLEDGMENTS

The authors thank Dr. Armando Chapin Rodríguez for his language editing, which substantially improved the quality of the article. This work was supported by a grant from Guangxi Higher Education Institutions (GZKZ10-114) to Jing Xu.

Jianyuan Meng and Jianhong Zhong are co-first authors.