The Role of Nutritional Support in the Treatment of Liver Malignancies

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Abstract

In order to describe the necessity and safety of nutritional support in liver malignancies, we performed a search and analysis of publications on the topic published in the medical databases eLibrary, PubMed, Medline. Based on the data obtained, it was shown that patients with malignant liver disease have anorexia-cachexia syndrome. Nutritional support for perioperative hepatic malignancies improves immediate surgical outcomes. Isocaloric enteral nutrition with a high protein content is considered the drug of choice. The additional use of branched chain amino acids (BCAA) is not unambiguously interpreted. When conducting modern anticancer treatment, nutritional support is considered as an integral component of complex therapy, contributing to the achievement of the best results at all stages of the treatment process.

About the authors

Olga A. Obukhova

National Medical Research Center of Oncology named after N.N. Blokhin

Author for correspondence.
Email: obukhova0404@yandex.ru
ORCID iD: 0000-0003-0197-7721
SPIN-code: 6876-7701

MD, PhD

Russian Federation, Moscow

Ildar A. Kurmukov

Moscow Clinical Scientific Center named after A.S. Loginov

Email: kurmukovia@gmail.com
ORCID iD: 0000-0001-8463-2600
SPIN-code: 3692-5202

MD, PhD, senior researcher

Russian Federation, Moscow

Grigory S. Yunaev

National Medical Research Center of Oncology named after N.N. Blokhin

Email: garik_dr@mail.ru
ORCID iD: 0000-0002-9562-9113
SPIN-code: 4410-8937
Russian Federation, Moscow

References

  1. Обухова О.А., Багрова С.Г., Бесова Н.С., и др. Оценка нутритивного статуса пациентов с неоперабельным раком желудка на момент начала противоопухолевого лечения. Предварительные результаты проспективного наблюдательного исследования // Трудный пациент. — 2018. — Т. 16. — № 6. — С. 6–11. [Obukhova OA, Bagrova SG, Besova NS, et al. Assessment of the nutritional status of patients with inoperable gastric cancer at the time of initiation of antitumor treatment. Preliminary results from a prospective observational study. Trudnyi patsient. 2018;16(6):6–11. (In Russ).]
  2. Бредер В.В., Косырев В.Ю., Кудашкин Н.Е., Лактионов К.К. Гепатоцеллюлярный рак в Российской Федерации как социальная и медицинская проблема // Медицинский совет. — 2016. — № 10. — С. 10–18. [Breder VV, Kosyrev VYu, Kudashkin NE, Laktionov KK. Hepatocellulose cancer in the Russian Federation as a social and medical problem. Meditsinskii sovet. 2016;(10):10–18. (In Russ).]
  3. Бредер В.В. Факторы риска развития гепатоцеллюлярного рака в онкологической практике. Опыт Российского Онкологического научного центра им. Н.Н. Блохина // Экспериментальная и клиническая гастроэнтерология. — 2016. — № 4. — С. 4–12. [Breder VV. Risk factors for hepatocellular carcinoma in oncology practice. The experience of the NN Blokhin Russian Cancer Research Center. Experimental & clinical gastroenterology. 2016;(4):4–12. (In Russ).]
  4. Lee YA, Cohet C, Yang Y, et al. Meta-analysis of epidemiologic studies on cigarette smoking and liver cancer. Int J Epidemiol. 2009;38(6):1497–1511. doi: 10.1093/ije/dyp280
  5. De Oliveira ML, Cunningham SC, Cameron JL, et al. Cholangiocarcinoma: thirty-one-year experience with 564 patients at a single institution. Ann Surg. 2007;245(5): 755–762. doi: 10.1097/01.sla.0000251366.62632.d3
  6. Shin HR, Oh JK, Masuyer E, et al. Epidemiology of cholangiocarcinoma: an update focusing on risk factors. Cancer Sci. 2010;101(3):579–585. doi: 10.1111/j.1349-7006.2009.01458.x
  7. Banales JM, Cardinale V, Carpino G, et al. Expert consensus document: Cholangiocarcinoma: current knowledge and future perspectives consensus statement from the European Network for the Study of Cholangiocarcinoma (ENS-CCA). Nat Rev Gastroenterol Hepatol. 2016;13(5): 261–280. doi: 10.1038/nrgastro.2016.51
  8. Desjardin M, Bonhomme B, Le Bail B, et al. Hepatotoxicities induced by neoadjuvant chemotherapy in colorectal cancer liver metastases: distinguishing the true from the false. Clin Med Insights Oncol. 2019;13:1179554918825450. doi: 10.1177/1179554918825450
  9. Вишневский В.А., Коваленко Ю.А., Андрейцева О.И., и др. Пострезекционная печеночная недостаточность: современные проблемы определения, эпидемиологии, патогенеза, оценки факторов риска, профилактики и лечения // Украинский журнал хирургии. — 2013. — № 3. — С. 172–182. [Vishnevsky VA, Kovalenko YuA, Andreytseva OI, et al. Post-resection hepatic failure: current problems of definition, epidemiology, pathogenesis, assessment of risk factors, prevention and treatment. Ukrainian Journal of Surgery. 2013;(3):172–182. (In Russ).]
  10. Ciuni R, Biondi A, Grosso G, et al. Nutritional aspects in patient undergoing liver resection. Updates Surg. 2011; 63(4):249–252. doi: 10.1007/s13304-011-0121-4
  11. Zhao Y, Deng Y, Peng J, et al. Does the preoperative prognostic nutritional index predict survival in patients with liver metastases from colorectal cancer who underwent curative resection? J Cancer. 2018;9(12):2167–2174. doi: 10.7150/jca.25346
  12. Muscaritoli M, Lucia S, Farcomeni A, et al. Prevalence of malnutrition in patients at first medical oncology visit: the PreMiO study. Oncotarget. 2017;8(45):79884–79896. doi: 10.18632/oncotarget.20168
  13. Hamaguchi Y, Kaido T, Okumura S, et al. Preoperative visceral adiposity and muscularity predict poor outcomes after hepatectomy for hepatocellular carcinoma. Liver Cancer. 2019;8(2):92–109. doi: 10.1159/000488779
  14. Обухова О.А. Необходима ли питательная поддержка больным с онкологическими заболеваниями? // Клиническая онкогематология. Фундаментальные исследования и клиническая практика. — 2009. — Т. 2. — № 4. — С. 343–348. [Obukhova OA. Is nutritional support needed for patients with cancer? Clinical hematology oncology. Basic research and clinical practice. 2009;2(4):343–348. (In Russ).]
  15. Plauth M, Bernal W, Dasarathy S, et al. ESPEN guideline on clinical nutrition in liver disease. Clin Nutr. 2019; 38(2):485–521. doi: 10.1016/j.clnu.2018.12.022
  16. Хващевская Г.М., Неробеева С.И., Бобков В.Я., Крыжановский В.Л. Основные клинические синдромы при заболеваниях гепатобилиарной системы: учебно-методическое пособие. — Минск: БГМУ, 2018. — 24 с. [Khvaschevskaya GM, Nerobeeva SI, Bobkov VYa, Kryzhanovsky VL. The main clinical syndromes in diseases of the hepatobiliary system: training manual. Minsk: BGMU; 2018. 24 p. (In Russ).]
  17. Hassanain M, Schricker T, Metrakos P, et al. Hepatic protection by perioperative metabolic support? Nutrition. 2008: 24(11–12):1217–1219. doi: 10.1016/j.nut.2008.05.019
  18. Sungurtekin H, Sungurtekin U, Balci C, et al. The influence of nutritional status on complications after major intraabdominal surgery. J Am Coll Nutr. 2004:23(3):227–232. doi: 10.1080/07315724.2004.10719365
  19. Richter B, Schmandra TC, Golling M, Bechstein WO. Nutritional support after open liver resection: a systematic review. Dig Surg. 2006;23(3):139–145. doi: 10.1159/000094345
  20. Lam VW, Poon RT. Role of branched-chain amino acids in management of cirrhosis and hepatocellular carcinoma. Hepatol Res. 2008;38(Suppl 1):107–115. doi: 10.1111/j.1872-034X.2008.00435.x
  21. Choudry HA, Pan M, Karinch AM, Souba WW. Branched-chain amino acid-enriched nutritional support in surgical and cancer patients. J Nutr. 2006;136(Suppl 1):314–318. doi: 10.1093/jn/136.1.314S
  22. Henkel AS, Buchman AL. Nutritional support in patients with chronic liver disease. Nat Clin Pract Gastroenterol Hepatol. 2006;3(4):202–209. doi: 10.1038/ncpgasthep0443
  23. Okabayashi T, Nishimori I, Sugimoto T, et al. Effects of branched-chain amino acids-enriched nutrient support for patients undergoing liver resection for hepatocellular carcinoma. J Gastroenterol Hepatol. 2008;23(12):1869–1873. doi: 10.1111/j.1440-1746.2008.05504.x
  24. Fan ST, Lo CM, Lai EC, et al. Perioperative nutritional support in patients undergoing hepatectomy for hepatocellular carcinoma. N Engl J Med. 1994;331(23):1547–1552. doi: 10.1056/NEJM199412083312303
  25. Hachiya H, Aoki T, Iso Y, et al. Effects of branched-chain amino acids on postoperative tumor recurrence in patients undergoing curative resection for hepatocellular carcinoma: a randomized clinical trial. J Hepatobiliary Pancreat Sci. 2020;27(11):819–829. doi: 10.1002/jhbp.830
  26. Ichikawa K, Okabayashi T, Maeda H, et al. Oral supplementation of branched-chain amino acids reduces early recurrence after hepatic resection in patients with hepatocellular carcinoma: a prospective study. Surg Today. 2013; 43(7):720–726. doi: 10.1007/s00595-012-0288-4
  27. Melloul E, Hübner M, Scott M, et al. Guidelines for perioperative care for liver surgery: enhanced recovery after surgery (ERAS) society recommendations. World J Surg. 2016;40(10):2425–2440. doi: 10.1007/s00268-016-3700-1
  28. Weimann A, Braga M, Carli F, et al. ESPEN guideline: Clinical nutrition in surgery. Clin Nutr. 2017;36(3): 623–650. doi: 10.1016/j.clnu.2017.02.013
  29. Yao H, Bian X, Mao L, et al. Preoperative enteral nutritional support in patients undergoing hepatectomy for hepatocellular carcinoma: a strengthening the reporting of observational studies in epidemiology article. Medicine (Baltimore). 2015;94(46):e2006. doi: 10.1097/MD.0000000000002006
  30. Yan X, Liu L, Zhang Y, et al. Perioperative enteral nutrition improves postoperative recovery for patients with primary liver cancer: a randomized controlled clinical trial. Nutr Cancer. 2020;1–9. doi: 10.1080/01635581.2020.1814824
  31. Свиридова С.П., Патютко Ю.И., Горожанская Э.Г., и др. Пострезекционная печеночная недостаточность у онкологических больных // Вестник интенсивной терапии. — 2010. — № 4. — С. 54–58. [Sviridova SP, Patyutko YuI, Gorozhanskaya EG, et al. Post-resection hepatic failure in cancer patients. Intensive care bulletin. 2010;(4):54–58. (In Russ).]
  32. Spotten LE, Corish CA, Lorton CM, et al. Subjective and objective taste and smell changes in cancer. Ann Oncol. 2017; 28(5):969–984. doi: 10.1093/annonc/mdx018
  33. Brisbois TD, de Kock IH, Watanabe SM, et al. Characterization of chemosensory alterations in advanced cancer reveals specific chemosensory phenotypes impacting dietary intake and quality of life. J Pain Symptom Manage. 2011;41(4)673–683. doi: 10.1016/j.jpainsymman.2010.06.022
  34. Boltong A, Keast R. The influence of chemotherapy on taste perception and food hedonics: a systematic review. Cancer Treat Rev. 2012;38(2):152–163. doi: 10.1016/j.ctrv.2011.04.008
  35. Boltong A, Keast R, Aranda S. Experiences and consequences of altered taste, flavour and food hedonics during chemotherapy treatment. Support Care Cancer. 2012; 20(11):2765–2774. doi: 10.1007/s00520-012-1398-7
  36. Bressan V, Bagnasco A, Aleo G, et al. The life experience of nutrition impact symptoms during treatment for head and neck cancer patients: a systematic review and meta-synthesis. Support Care Cancer. 2017;25(5):1699–1712. doi: 10.1007/s00520-017-3618-7
  37. De Haan JJ, Moshage Y, Kluifhooft D, et al. Impact of taste alterations during systemic anti-tumour therapy on the liking of oral nutritional supplements with adapted flavours. Ann Oncol. 2018;(Suppl 8):viii620. doi: 10.1093/annonc/mdy300.054
  38. Спиридонов В.К., Толочко З.С. Капсаицин-чувствительные нервы и окислительный стресс // Бюллетень Сибирского отделения Российской академии медицинских наук. — 2010. — Т. 30. — № 4. — С. 76–81. [Spiridonov VK, Tolochko ZS. Capsacin-sensory nerves and oxidative stress. Bulletin of the Siberian Branch of the Russian Academy of Medical Sciences. 2010;30(4):76–81. (In Russ).]
  39. Liu B, Fan L, Balakrishna S, et al. TRPM8 is the principal mediator of menthol-induced analgesia of acute and inflammatory pain. Pain. 2013;154(10):2169–2177. doi: 10.1016/j.pain.2013.06.043
  40. Обухова О.А., Кашия Ш.Р., Курмуков И.А., и др. Применение дополнительного орального питания при проведении противоопухолевой химиотерапии. Проспективное рандомизированное контролируемое исследование // Вестник интенсивной терапии. — 2009. — № 3. — С. 47–52. [Obukhova OA, Kashiya ShR, Kurmukov IA, et al. The use of additional oral nutrition during anticancer chemotherapy. A prospective randomized controlled trial. Intensive care bulletin. 2009;(3):47–52. (In Russ).]
  41. Arends J, Bachmann P, Baracos V, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36(1): 11–48. doi: 10.1016/j.clnu.2016.07.015

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