Perioperative exercise for chronic liver injury patients with hepatocellular carcinoma undergoing hepatectomy

Abstract Background The aim of this study was to examine the outcomes of exercise therapy in patients with hepatocellular carcinoma who underwent hepatectomy. Methods Fifty-one patients with hepatocellular carcinoma were randomized to diet therapy alone (n = 25) or to exercise in addition to diet therapy (n = 26). Exercise at the anaerobic threshold of each patient was started 1 month preoperatively, resumed from 1 week postoperatively, and continued for 6 months. Results Whole body mass and fat mass in the exercise group compared with the diet group were significantly decreased at 6 months postoperatively. Fasting serum insulin and the homeostasis model assessment score were also significantly decreased. At 6 months, anaerobic threshold and peak oxygen consumption were significantly increased, while serum insulin and insulin resistance were significantly improved in a high-frequency exercise subgroup compared with a low-frequency group. Conclusions Perioperative exercise therapy for patients with hepatocellular carcinoma with liver dysfunction may improve insulin resistance associated with hepatic impairment and suggests a benefit to the early resumption of daily exercise after hepatectomy.