Effects of exercise training on muscle mass and physical function in patients with hepatocellular carcinoma after diagnosis: a systematic review

Background & Aims: Decreased muscle mass and physical function are common complications in hepatocellular carcinoma (HCC) patients which are associated with increased morbidity and mortality. Thus, there have been targeted efforts to prevent and/or improve both by enrolling these patients in exercise training programs. We performed a systematic review to evaluate the effects of exercise training on muscle mass and physical function in people with HCC after diagnosis.

Methods: A systematic literature search was conducted using the Medline, Base, PubMed, Cochrane and Scopus, and trial registries, through April 2023 for studies that assessed the effects of an exercise training program in adults with HCC. The primary outcomes were muscle mass and physical function. To assess the risk of bias, we used the Quality Assessment Tool for Quantitative Studies from the Effective Public Health Practice Project.

Results: Eight studies met inclusion criteria, comprising a total of 809 participants. Interventions included aerobic exercise training, resistance exercise training, balance and flexibility training, or home-based exercise training. Four studies showed statistically significant improvements in at least one muscular outcome. Three studies showed a maintenance of muscular outcomes, and one a decrease in muscle mass. Four articles showed statistically improvements in at least one physical fitness variable, two showed a maintenance of physical function variable.

Conclusion: Together the results suggest that patients may benefit from physical exercise training after treatment to improve muscle mass and physical function.