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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 28, 2016; 22(32): 7252-7263
Published online Aug 28, 2016. doi: 10.3748/wjg.v22.i32.7252
Supportive therapies for prevention of hepatocellular carcinoma recurrence and preservation of liver function
Taro Takami, Takahiro Yamasaki, Issei Saeki, Toshihiko Matsumoto, Yutaka Suehiro, Isao Sakaida
Taro Takami, Issei Saeki, Isao Sakaida, Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi 755-8505, Japan
Takahiro Yamasaki, Toshihiko Matsumoto, Yutaka Suehiro, Department of Oncology and Laboratory Medicine, Yamaguchi University Graduate School of Medicine, Yamaguchi 755-8505, Japan
Author contributions: Takami T analyzed the literature and was involved mainly in writing and editing the manuscript; Saeki I and Matsumoto T analyzed the literature and wrote the manuscript; Yamasaki T analyzed the literature and was involved in writing and critical editing of the manuscript; Suehiro Y was involved in editing the manuscript; Sakaida I was involved in critical editing of the manuscript.
Supported by Japan Society for the Promotion of Science, KIBAN-C, No. 26461009.
Conflict-of-interest statement: The authors have no conflict of interest to report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Takahiro Yamasaki, MD, PhD, Department of Oncology and Laboratory Medicine, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami Kogushi, Ube, Yamaguchi 755-8505, Japan. t.yama@yamaguchi-u.ac.jp
Telephone: +81-836-222336 Fax: +81-836-222338
Received: April 8, 2016
Peer-review started: April 9, 2016
First decision: May 12, 2016
Revised: June 7, 2016
Accepted: July 21, 2016
Article in press: July 21, 2016
Published online: August 28, 2016
Processing time: 137 Days and 22.4 Hours
Abstract

Hepatocellular carcinoma (HCC) is one of the deadliest cancers in the world and is associated with a high risk of recurrence. The development of a wide range of new therapies is therefore essential. In this study, from the perspective of supportive therapy for the prevention of HCC recurrence and preservation of liver function in HCC patients, we surveyed a variety of different therapeutic agents. We show that branched chain amino acids (BCAA) supplementation and late evening snack with BCAA, strategies that address issues of protein-energy malnutrition, are important for liver cirrhotic patients with HCC. For chemoprevention of HCC recurrence, we show that viral control after radical treatment is important. We also reviewed the therapeutic potential of antiviral drugs, sorafenib, peretinoin, iron chelators. Sorafenib is a kinase inhibitor and a standard therapy in the treatment of advanced HCC. Peretinoin is a vitamin A-like molecule that targets the retinoid nuclear receptor to induce apoptosis and inhibit tumor growth in HCC cells. Iron chelators, such as deferoxamine and deferasirox, act to prevent cancer cell growth. These chelators may have potential as combination therapies in conjunction with peretinoin. Finally, we review the potential inhibitory effect of bone marrow cells on hepatocarcinogenesis.

Keywords: Hepatocellular carcinoma; Liver cirrhosis; Branched-chain amino acids; Late evening snack; Iron chelators; Bone marrow cells

Core tip: Hepatocellular carcinoma (HCC) is one of the deadliest cancers in the world and is associated with a high risk of recurrence. Because liver function worsens upon repeated treatment for HCC recurrence, therapies that preserve liver function are essential. Here, we survey a variety of different therapeutic agents and then review the current status and prospects for prevention of HCC recurrence, particularly from the perspective of supportive therapy to preserve liver function. The agents included branched-chain amino acids (BCAA) supplementation, late evening snacking with BCAA, antiviral drugs, sorafenib, peretinoin, iron chelators, and bone marrow cells.