Effect of gluconeogenic diet on primary hepatoma patients.

Three inoperable patients with primary hepatoma could be placed on gluconeogenic diets (minimum carbohydrate-high fat diets) for one to three months. A transient inhibition or a marked retardation of the tumor growth was observed with these patients and their entire clinical courses were fairly good. These results confirmed our previous observation with a metastatic liver tumor patient. ∗PMID: 4333631 [PubMed indexed for MEDLINE] Copyright c ©OKAYAMA UNIVERSITY MEDICAL SCHOOL Acta Med. O~ayama 25, 143-163 (1971) EFFECT OF GLUCONEOGENIC DIET ON PRIMARY HEPATOMA PATIENTS Kazuhisa TAKETA and Kiyowo KOSAKA Department of Internal Medicine, Okayama University Medical School, Okayama, Japan (Director: Prof. K. Kosaka) Received for publication, February 25, 1971 In our previous study (l) attempted to extend the gluconeogenic dietary therapy of the Novikoff hepatoma (2) to humans, a transient but definite growth.inhibiting effect of a low carbohydrate-high fat diet was observed on a patient with hepatic metastases of malignant melanoma. Since the original observation was made with the hepatoma transplanted into the liver, the most pertinent subjects to be studied with the gluconeogenic diet would be primary hepatoma patients. The present paper reports three cases of primary hepatoma placed on gluconeogenic diets for one to three months and then returned to balanced diets. The tumor growth was inhibited transiently or slowed considerably during the period of the low carbohydrate regimens. METERIALS AND METHODS The principle and practical techniques of placing hepatoma patients on gluconeogenic diets were essentially the same as those reported previow3ly (1). Four inoperable primary hepatoma and one cystic liver patients admitted to the clinic of the University Department were the subjects of the present study. Except one primary hepatoma, these patients had cirrhosis of the liver. One of the hepatoma patients with cirrhosis of the liver could not tolerate the gluconeogenic diet and served as a control. The cystic liver patient was treated with the gluconeogenic diet as primary hepatoma before the diagnosis was established and was also included as another control to see the effect of the diet on cirrhotic patients. Metabolite concentrations and enzyme activities in the blood or serum were determined as described in the previous paper (1) or according to the routine laboratory methods. Activities of liver and tumor hexokinase (3), glucose 6-phosphate dehydrogenase (1), and fructose 1,6-diphosphatase (4) were also measured at 37°e in some of the patients on necropsied materials. The days after starting the record of daily dietary intakes were referred to as the days of dietary treatment throughout the present paper.