Nutrition and Hepatocellular Cancer

Abstract

Background: Hepatocellular carcinoma (HCC) significantly contributes to the global burden of cancer. Liver cancer is the third most frequent cause of cancer-related death with HCC representing more than 90% of primary liver cancers. The majority of patients are not only affected by the malignant disease but do also suffer from chronic liver disease. Therefore, several factors impact on the prognosis of patients with HCC, including tumor-related factors, liver function and patient-related factors such as performance status and other comorbidities. The nutritional status is of high significance for the patients' performance status, the tolerance of tumor-targeting therapy and the prognosis of cancer of any type and is specially referenced in HCC. This overview is on current concepts on the role of nutritional factors in hepatocarcinogenesis and the role of nutrition in patients affected by HCC. Summary: Nutritional status and composition of diet are relevant factors related to the risk of HCC. They also have an important role concerning the prognosis of patients with HCC. Besides risk factors, several macro-and micronutrient components have been found to be inversely correlated with the risk of HCC. To prevent disease progression to liver cirrhosis or HCC in patients with nonalcoholic steatohepatitis, it is crucial to optimize the metabolic state. Key Message and Practical Implication: Evidence from well-designed prospective interventional trials with the aim to reduce the HCC incidence or to prolong survival in patients with HCC based on nutritional modification is still to be generated.

A novel combined systemic inflammation-based score can predict survival of intermediate-to-advanced hepatocellular carcinoma patients undergoing transarterial chemoembolization

“…For example, hepatic albumin biosynthesis is downregulated by pro-inflammatory stimuli as part of a negative acute phase reaction in patients with malignancy [ 23 ]. Previous studies have demonstrated the independent prognostic value of hypoalbuminemia in HCC [ 24 , 25 ], and a prospective clinical study revealed malnutrition as an independent negative prognostic risk factor in HCC patients [ 26 ]. Accordingly, numerous studies have also shown better recurrence-free survival (RFS) and OS after curative treatment of HCC if the nutritional status was optimized before treatment by supplementation of branched-chain amino acids [ 27 , 28 ].…”

Geriatric nutritional risk index predicts prognosis after hepatectomy in elderly patients with hepatitis B virus-related hepatocellular carcinoma

“…In older in-patients, malnutrition is associated with poor clinical outcomes, including impairment in quality of life, performance status, immune function and liver function, as well as decreased survival. Several studies 5 – 7 reported a relationship between preoperative nutritional status and poor prognosis in HCC patients. However, the correlation between preoperative nutritional status and prognosis in elderly patients with HCC remains unclear and deserves investigation.…”

Association between dietary patterns and prognosis of hepatocellular carcinoma in the Guangdong liver cancer cohort study

“…The nutritional status of patients is of great importance for their performance status and the tolerance of anticancer therapy. 27 Malnutrition has been identified as an independent predictor for poor diagnosis of HCC. 28 In the current study, patients with advanced and terminal cancers frequently had cachexia, which consumed a large amount of nutrients and could be the reason why we did not detect the beneficial role of a healthy diet among patients with advanced and late TNM stages.…”