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| 1 | Trans-arterial chemo-embolization is safe and effective for very elderly patients with hepatocellular carcinoma显示文摘AIM: To assess the safety and efficacy of trans-arterial chemo-embolization (TACE) in very elderly patients. METHODS: A prospective cohort study, from 2001 to 2010, compared clinical outcomes following TACE between patients ≥ 75 years old and younger patients (aged between 65 and 75 years and younger than 65 years) with hepatocellular carcinoma (HCC), diagnosed according to the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases criteria. The decision that patients were not candidates for curative therapy was made by a multidisciplinary HCC team. Data collected included demographics, co-morbidities, liver disease etiology, liver disease severity and the number of procedures. The primary outcome was mortality; secondary outcomes included post-embolization syndrome (nausea, fever, abdominal right upper quadrant pain, increase in liver enzymes with no evidence of sepsis and with a clinical course limited to 3-4 d post procedure) and 30-d complications. Additionally, changes in liver enzyme measurements were assessed [alanine and aspartate aminotransferase (ALT and AST), gamma-glutamyl transpeptidase and alkaline phosphatase] in the week following TACE. Analysis employed both univariate and multivariate methods (Cox regression models). RESULTS: Of 102 patients who underwent TACE as sole treatment, 10 patients (9.8%) were > 80 years old at diagnosis; 13 (12.7%) were between 75 and 80 years, 45 (44.1%) were between 65 and 75 years and 34 (33.3%) were younger than 65 years. Survival analysis demonstrated similar survival patterns between the elderly patients and younger patients. Age was also not associated with the adverse event rate. Survival rates at 1, 2 and 3 years from diagnosis were 74%, 37% and 31% among patients < 65 years; 83%, 66% and 48% among patients aged 65 to 75 years; and 86%, 41% and 23% among patients ≥ 75 years. There were no differences between the age groups in the pre-procedural care, including preventive treatment for contrast nephropathy and prophylactic antibiotics. Multivariate survival analysis, controlling for disease stage at diagnosis with the Barcelona Clinic Liver Cancer score, number of TACE procedures, sex and alphafetoprotein level at the time of diagnosis, found no significant difference in the mortality hazard for elderly vs younger patients, and there were no differences in post-procedural complications. Serum creatinine levels did not change after 55% of the procedures, in all age groups. In 42% of all procedures, serum creatinine levels increased by no more than 25% above the baseline levels prior to TACE. Overall, there were 69 post-embolization events (23%). Hepatocellular enzymes often increased following TACE, with no association with prognosis. In 40% of the procedures, ALT and AST levels rose by at least 100%. The increases in hepatocellular enzymes occurred similarly in all age groups. CONCLUSION: TACE is safe and effective in very elderly patients with HCC, and is not associated with decreased survival or increased complication rates. | Matan J Cohen Allan I Bloom Orly Barak Alexander Klimov Tova Nesher Daniel Shouval Izhar Levi Oren Shibolet | 2013 | World Journal of Gastroenterology2013，19，16： | 13 |
| 2 | Permissive second- ary mutations enable the evolution of influenza oseltami- vir resistance 显示文摘 | Bloom J D Gong L I Baltimore D | 2010 | Science2010，328，5983： | 1 |
| 3 | Calendar- and cycle-life studies of advanced technology development program generation 1 lithium-ion batteries显示文摘 | R.B Wright C.G Motloch J.R Belt J.P Christophersen C.D Ho R.A Richardson I Bloom S.A Jones V.S Battaglia G.L Henriksen T Unkelhaeuser D Ingersoll H.L Case S.A Rogers R.A Sutula | 2002 | Journal of Power Sources2002，，2： | 1 |
| 4 | Quantum efficiency and crosstalk of an improved backside-illuminated indium antimonide focal-plane array显示文摘 | Bloom I Nemirovsky Y | 1991 | IEEE Transactions on Electron Devices1991，38，8： | 1 |
| 5 | Effect of cathode composition on capacity fade, impedance rise and power fade in high-power, lithium-ion cells 显示文摘 | BLOOM I JONES S A BATTAGLIA V S | 2003 | J Power Sources2003，124，2： | 1 |
| 6 | Oxidative stress markers are associated with persistent atrial fibrillation显示文摘 | Neuman RB Bloom HL Shukrullah I | 2007 | Clin Chem2007，53，9： | 1 |
| 7 | Calendar and PHEV cyclelife aging of high-energy, lithium-ion cells containing blendedspinel and layered-oxide cathodes 显示文摘 | BELTA J UTGIKARB V BLOOM I | 2011 | Journal of Power Sources2011，196，10： | 1 |
| 8 | Intraosseous infusion in children显示文摘 | Claudet I Alberge C Bloom MC | 1999 | Ann Fr Anesth Reanim1999，18，3： | 1 |
| 9 | Oxidative stress markers are associated with persistent atrial fibrillation 显示文摘 | Neuman RB Bloom HL Shukrullah I | 2007 | Clin Chem2007，53，9： | 1 |
| 10 | An accelerated calendar and cycle life study of Li-ion cells显示文摘 | I Bloom B.W Cole J.J Sohn S.A Jones E.G Polzin V.S Battaglia G.L Henriksen C Motloch R Richardson T Unkelhaeuser D Ingersoll H.L Case | 2001 | Journal of Power Sources2001，，2： | 1 |
| 11 | Contribution of α-gustducin to taste-guided licking responses of mice显示文摘 | Glendinning J I Bloom L D Onishi M | 2005 | Chem Senses2005，30，： | 1 |
| 12 | Rate-based degradation modeling of lithium-ion cells显示文摘 | THOMAS E V BLOOM I CHRISTOPHERSEN J P | 2012 | Journal of Power Sources2012，206，： | 1 |
| 13 | Post-test analysis of battery materials:Another part of the question显示文摘 | Bloom I Rago N D Jansen A N | 2014 | ECS Transactions2014，61，27： | 1 |
| 14 | An accelerated calendar and cycle life study of Li-ion cells显示文摘 | Bloom I Cole B W Sohn J J | 2001 | Journal of Power Sources2001，101，2： | 1 |
| 15 | Group support for patients withmetastatic cancer:a randomized outcome study显示文摘 | Spiegel D Bloom JR Yalom I | 1981 | Arch Gen Psychiatry1981，38，5： | 1 |
| 16 | Imitation dynamics of vaccination bchaviour on social networks显示文摘 | FU feng ROSEN'BLOOM D I WANG long | 2011 | Proceedings of the Royal Society B: Biological Sciences2011，278，1702： | 1 |
| 17 | Competition and innovation: An in- verted U relationship 显示文摘 | I Aghion P Bloom Netal | 2005 | Quarterly Journal of Economics2005，20，2： | 1 |
| 18 | Fibrin D-dimer as a marker of disease altivity in systemic onset juvenile rheumatoid arthritis显示文摘 | Bloom B j Tucker L B Millor I C | 1998 | J Rheumatol1998，25，8： | 1 |
| 19 | Targeted therapy in breast cancer: The HER -2/neu gane and protein 显示文摘 | Ross JS Fletcher JA Bloom K I | 2004 | Mol Cell Pro- teomics2004，3，4： | 1 |
| 20 | Differential control of eosinophil survival by glucocorticoids 显示文摘 | Bloom J W Chaeho J Lohman I C | 2004 | Apoptosis2004，9，1： | 1 |
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