Nutritional Therapy in Patients with Hepatocellular Carcinoma after Liver Resection or Ablation: A Systematic Review of Randomized Controlled Trials

Background Despite advances in the treatment of hepatocellular carcinoma (HCC), the long-term prognosis for patients remains challenging due to incidences of postoperative morbidity, tumour recurrence and mortality. Some findings have shown that optimising nutritional status may be a potential strategy for preserving residual function and improving clinical outcomes in patients with HCC. However, comprehensive evidence is lacking. Therefore, this study systematically analyses randomized controlled trials (RCTs) to present the effects of nutritional therapy in patients with HCC following resection or ablation. Method A comprehensive database search was conducted on PubMed, Google Scholar, Scopus, and Web of Science using appropriate keywords and Boolean operators (AND, OR). Eligibility criteria guided the selection of the articles, ensuring that only RCTs focusing on the effect of nutritional therapy in patients with HCC after liver resection or ablation were selected. Results Out of the 3,155 articles screened, 13 studies were included. The nutritional interventions included branched-chain amino acids, protein-enriched enteral formulas, omega-3 fatty acid supplementation, and vitamin-based therapies. Survival and recurrence outcomes varied across studies, with most showing significant improvement with nutritional interventions, while 5 studies showed non-significant findings. Post-operative recovery, hospital stay, liver function, quality of life, and functional status showed improvement across the intervention group compared to the control group. Conclusion Nutritional therapies confer significant benefits for patients with HCC undergoing curative resection or ablation. Although the findings of some outcomes were non-significant, nutritional therapies hold potential in improving post-operative care in patients with HCC. Further multicentre studies are needed to validate these findings and facilitate their integration into clinical practice. PROSPERO Registration number : CRD420251151815