Physical activity and exercise in liver cancer^☆

Abstract

Sarcopenia and physical deconditioning are common complications in patients with liver cancer, which are frequently caused by insufficient physical activity and poor nutritional status, resulting in physical frailty and a significant impact on the patient’s physical fitness. Notably, sarcopenia, frailty, and poor cardiopulmonary endurance have all been linked to higher mortality rates among patients with liver cancer. Exercise intervention significantly improves various health parameters in liver cancer patients, including metabolic syndrome, muscle wasting, cardiorespiratory endurance, health-related quality of life, and reduction in hepatic venous pressure gradient. However, the link between physical exercise and liver cancer is commonly overlooked. In this article, we will examine the impact of exercise on liver cancer and present the most recent evidence on the best types of exercise for various stages of liver cancer. This article also summarizes and discusses the molecular mechanisms that control metabolism and systemic immune function in tumors. In brief, physical exercise should be considered an important intervention in the prevention and treatment of liver cancer and its complications.

Keywords

Physical activity (PA) / Exercise / Liver cancer / Sarcopenia / Frailty / Rehabilitation

Authors' contributions

Haiyan Chen, Huimin Zhou, and Bo Wu contributed equally to this work and should be considered co-first authors. Haiyan Chen: Writing - original draft, Investigation. Huimin Zhou: Writing - orig-inal draft, Investigation. Bo Wu: Writing - original draft, Visualiza-tion, Software. Hanxiao Lu: Visualization, Software, Data curation. Jie Zhang: Validation, Investigation. Yan Zhang: Validation, Investiga-tion. Yuanlong Gu: Validation, Funding acquisition. Guangwen Zhou: Validation, Supervision, Methodology. Jie Xiang: Writing - review & editing, Conceptualization. Jun Yang: Writing - review & editing, Visualization, Validation, Supervision, Project administration, Fund-ing acquisition, Conceptualization. All authors read and approved the final manuscript.

Declaration of competing interest

The authors declare that there is no conflicts of interest.

Acknowledgements

This work was supported by grants from Top Talent Support Program for young and middle-aged people of Wuxi Health Com-mittee (No.BJ2023049, China); Wuxi Social Development Science and Technology Demonstration Project (No.20201003, China).

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