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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 | Immune Response to Influenza Vaccine in Pediatric Patients With Inflammatory Bowel Disease显示文摘 | Petar Mamula Jonathan E. Markowitz David A. Piccoli Alexander Klimov Louis Cohen Robert N. Baldassano | 2007 | Clinical Gastroenterology and Hepatology2007，，7： | 2 |
| 3 | Clonal structure of Yersinia pestis populations in experimental soil ecosystems显示文摘 | Breneva NV Maramovich AS Klimov VT | 2007 | Zh Mikrobiol Epidemiol Immunobiol2007，，1： | 1 |
| 4 | Seawater pH sensor based on the long period grating in a single-mode-multimode-single-mode structure 显示文摘 | WANG Ke KLIMOV D KOLBER Z | 2009 | Optical Engineering2009，48，3： | 1 |
| 5 | Elec- tro-plasticity of metals显示文摘 | KLIMOV K M SHNYREV G D NOVIKOV I I | 1974 | Doklady Akademii Nauk SSSR1974，219，2： | 1 |
| 6 | Recombinant influenza A virus vaccines for the pathogenic human A/Hong Kong/97 (H5N1) viruses显示文摘 | Li S Liu C Klimov A | 1999 | J Infect Dis1999，179，5： | 1 |
| 7 | A new class of Invertible mappings 显示文摘 | KLIMOV A SHAMIR A | 2002 | LNCS2002，，2523： | 1 |
| 8 | Theory of the Shim- my Phenomenon显示文摘 | Ph Zhuravlev V Klimov D M | 2010 | Mechanical of Solids2010，45，3： | 1 |
| 9 | Neuraminidase inhibitor sus- ceptibility testing of influenza type B viruses in China during 2010 and 2011 identifies viruses with reduced susceptibility to oseltamivir and zanamivir显示文摘 | Wang D Sleeman K Huang W Nguyen H T LevineM Cheng Y Li X Tan M Xing X Xu X Klimov A I Gubareva L V Shu Y | 2013 | Antiviral Research2013，97，3： | 1 |
| 10 | Relativistic X band BWO with 3-GW output power显示文摘 | C-unin A V Klimov A I Korovin S D | 1998 | IEEE Trans on Plasma Sci1998，26，3： | 1 |
| 11 | Modified M2 proteins produce heterotypic immunity against influenza A virus显示文摘 | Frace A M Klimov A I Rowe T | 1999 | Vaccine1999，17，： | 1 |
| 12 | A vircator with electron beam premodulation based on high current repetitively pulsed accel-erator显示文摘 | Kitsanov S A Klimov A I Korovin S D | 2002 | IEEE Trans Plas Sci2002，30，1： | 1 |
| 13 | Surveillance and impact of influenza in the United States显示文摘 | Klimov A Simonsen L Fukuda K | 1999 | Vaccine1999，，： | 1 |
| 14 | Inhibition of neuraminidase inhibitor-resistant influenza virus by DAS181, a novel sialidase fusion proteln显示文摘 | TRIANA-BALTZER G B GUBAREVA L V KLIMOV A I | 2009 | PLoS One2009，4，11： | 1 |
| 15 | Measurement of parameters of X-band high-power microwave superradiative pulses显示文摘 | Klimov A I Kovalchuk O B Rostov V V | 2008 | IEEE Trans on Plasma Sci2008，36，3： | 1 |
| 16 | Modified M2 proteins produce heterotypic immunity against influenza A virus显示文摘 | Frace A M Klimov A I Rowe T | 1999 | Vaccine1999，17，18： | 1 |
| 17 | Chemical mechanical planarization of copper: role of oxidants and inhibitors 显示文摘 | Deshpande S Kuiry S C Klimov M | 2004 | Journal of the Electrochemical Society2004，151，： | 1 |
| 18 | Co-Mo catalysts for ultra-deep HDS of diesel fuels prepared via synthesis of bimetallic surface compounds 显示文摘 | KLIMOV O V PASHIGREVA A V FEDOTOV M A | 2010 | Journal of Molecular Catalysis A: Chemical2010，322，12： | 1 |
| 19 | Innovative nuclear technology based on modular multi-purpose lead–bismuth cooled fast reactors显示文摘 | A.V. Zrodnikov G.I. Toshinsky O.G. Komlev Yu.G. Dragunov V.S. Stepanov N.N. Klimov V.N. Generalov I.I. Kopytov V.N. Krushelnitsky | 2007 | Progress in Nuclear Energy2007，，2： | 1 |
| 20 | Mutually unbiased bases and generalized Bell states显示文摘 | Klimov A B Syeh D Sanchez-Soto L L | 2009 | Phys Rev A2009，79，05： | 1 |
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