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

BMC Gastroenterology

Research Article

Sawako Yoshiuchi¹  Daiki Habu²  Morihiko Ishizaki³  Kosuke Matsui³  Richi Nakatake³  A Hon Kon³  Tatsuma Sakaguchi³  Masaki Kaibori⁴  Yutaka Kimura⁵ 

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

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

DOI  :  10.1186/1471-230X-13-119

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

来源: Springer

【 摘 要 】

BackgroundCardiopulmonary 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.MethodsSixty-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.ResultsMultivariate 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.ConclusionsThis 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】

CC BY   
© Kaibori et al.; licensee BioMed Central Ltd. 2013