Assessment of preoperative exercise capacity in hepatocellular carcinoma patients with chronic liver injury undergoing hepatectomy

BMC Gastroenterology

A Hon Kon⁵  Yutaka Kimura³  Sawako Yoshiuchi⁴  Daiki Habu²  Tatsuma Sakaguchi⁵  Richi Nakatake⁵  Kosuke Matsui⁵  Morihiko Ishizaki⁵  Masaki Kaibori¹ 

[1] Masaki Kaibori, Department of Surgery, Hirakata Hospital, Kansai Medical University, 2-3-1 Shinmachi, 573-1191 Hirakata, Osaka, Japan;Department of Nutritional Medicine, Graduate School of Human Life Science, Osaka City University, 545-8585 Osaka, Japan;Health Science Center, Hirakata Hospital, Kansai Medical University, 573-191 Hirakata, Osaka, Japan;Department of Nutrition Management, Hirakata Hospital, Kansai Medical University, 573-191 Hirakata, Osaka, Japan;Department of Surgery, Hirakata Hospital, Kansai Medical University, 573-191 Hirakata, Osaka, Japan

关键词: BCAA/tyrosine ratio;    Exercise capacity;    Hepatectomy;    Chronic liver injury;    Liver cancer;   

Others  :  857772
DOI  :  10.1186/1471-230X-13-119

 received in 2012-08-30, accepted in 2013-07-19,  发布年份 2013

【 摘 要 】

Background

Cardiopulmonary exercise testing measures oxygen uptake at increasing levels of work and predicts cardiopulmonary performance under conditions of stress, such as after abdominal surgery. Dynamic assessment of preoperative exercise capacity may be a useful predictor of postoperative prognosis. This study examined the relationship between preoperative exercise capacity and event-free survival in hepatocellular carcinoma (HCC) patients with chronic liver injury who underwent hepatectomy.

Methods

Sixty-one HCC patients underwent preoperative cardiopulmonary exercise testing to determine their anaerobic threshold (AT). The AT was defined as the break point between carbon dioxide production and oxygen consumption per unit of time (VO₂). Postoperative events including recurrence of HCC, death, liver failure, and complications of cirrhosis were recorded. Univariate and multivariate analyses were performed to evaluate associations between 35 clinical factors and outcomes, and identify independent prognostic indicators of event-free survival and maintenance of Child-Pugh class.

Results

Multivariate analyses identified preoperative branched-chain amino acid/tyrosine ratio (BTR) <5, alanine aminotransferase level ≥42 IU/l, and AT VO₂ <11.5 ml/min/kg as independent prognostic indicators of event-free survival. AT VO₂ <11.5 ml/min/kg and BTR <5 were identified as independent prognostic indicators of maintenance of Child-Pugh class.

Conclusions

This study identified preoperative exercise capacity as an independent prognostic indicator of event-free survival and maintenance of Child-Pugh class in HCC patients with chronic liver injury undergoing hepatectomy.

【 授权许可】

   
2013 Kaibori et al.; licensee BioMed Central Ltd.

【 图 表 】

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