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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 | Artisan aphakic intraocular lens in children with subluxated crystalline lenses 显示文摘 | Lifshitz T Levy J Klemperer I | 2004 | J Cataract Refract Surg2004，30，9： | 1 |
| 3 | Signal-to-noise ratio enhancement in multichannel seismic data via the Karhunen-Loeve transform显示文摘 | Jones I F Levy S | 1987 | Geophysical Prospecting1987，35，： | 1 |
| 4 | On Idempotent Ranks of Semigroups of Partial Transformations 显示文摘 | BARNES G LEVI I | 2005 | Semigroup Forum2005，70，： | 1 |
| 5 | Microcirculation in Hypertension: A new target for treatment? 显示文摘 | LEVY B I AMBROSIO G PRIES A R | 2001 | Circulation2001，104，： | 1 |
| 6 | Vascular calcium overload produced by vitamin D3 plus nicotine treatment diminishes arterial distensibility in rats显示文摘 | Atkinson J Poitevin P Chillon JM Lartaud I Levy B | 1994 | Am J Physiol1994，266，2： | 1 |
| 7 | Summary of the 2008 BTS/ SIGN British guideline on the management of asthma 显示文摘 | Levy ML Thomas M Small I | 2009 | Prim Care Respir J2009，181，： | 1 |
| 8 | Nilpotent Ranks of Semigroups of Partial Transformations 显示文摘 | LEVI I | 2006 | Semigroup Forum2006，72，： | 1 |
| 9 | Serizurs and cerebral in farction in the full newborn显示文摘 | Levy S R Abroms I F Marshall P C | 1985 | Ann Neurol1985，17，： | 1 |
| 10 | Effects of HA- rich n - 3 fatty acid supplementation on gene expression in blood on- onuclear leukocytes:The OmegAD study显示文摘 | Vedin I Cederholm T Freund - Levi Y | 2012 | US National Library of Medicine National Institutes of Health2012，7，35： | 1 |
| 11 | Oxidation of 4-bromophenol by recombinant cellulose binding domain horseradish peroxidase fused protein immobilized to cellulose显示文摘 | Ward G Hadar Y | 2003 | Biotechnol Bioeng2003，82，： | 1 |
| 12 | Three-question depres- sion screener used for lumbar disc herniations and spinal stenosis 显示文摘 | LEVY H I HANSCOM B BODEN S D | 2002 | Spine(phila pa 1976)2002，，27： | 1 |
| 13 | Terminating migraine with allodynia and ongoing central sensitization using parenteral administration of COX1/COX2 inhibitors显示文摘 | Jakubowski M Levy D Itay Goor-Aryeh I | 2005 | Headache2005，45，： | 1 |
| 14 | Pre-wetting rate and aging effect on seal formation and interrill soil erosion显示文摘 | Levy G J Levin J Shainberg I | 1997 | Soil Science1997，162，： | 1 |
| 15 | What limits performance in the amblyopic visual system:seeing signals in noise with an amblyopic brain显示文摘 | Levi DM Klein SA Chen I | 2008 | J Vis2008，8，4： | 1 |
| 16 | Reversal of activation of human myofibroblast-like cells by culture on a basement membrane-like substrate 显示文摘 | Sohara N Znoyko I Levy MT | 2002 | J Hepatol2002，37，2： | 1 |
| 17 | Radiosurgery for Childhood Intracranial Arteriovenous Malformations 显示文摘 | Levy E I Niranjan A Thompson T P | 2000 | Neurosurgery2000，47，： | 1 |
| 18 | Characteristics of a widespread community cluster of H275Y oseltamivir-resistant A (H1N1) pdm09 influenza in Australia显示文摘 | Hurt A C Hardie K Wilson N J Deng Y M Oshourn M Leang S K Lee R T Iannello P Gehrig N Shaw R Wark P Caldwell N Givney R C Xue L Maurer- Stroh S Dwyer D E Wang B Smith D W Levy A Booy R Dixit R Merritt T Kelso A Dalton C Durrheim D Barr I G | 2012 | J Infect Dis2012，206，2： | 1 |
| 19 | Current perspe- ctives on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases 显示文摘 | SAFAR M E LEVY B I STRUHKER H | 2003 | Circulation2003，107，10： | 1 |
| 20 | The preparation of magnetic proteinaceous microspheres using the sonochemical method显示文摘 | I Felner I Novik | 2001 | Biochimica et Biophysica Acta2001，1527，： | 1 |
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