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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 | Cytoreductive surgeryand intraperitoneal hyperthermic chemotherapy in peritoneal car-cinomatosis显示文摘 | Nesher E Greenberg R Avital S | 2007 | Isr Med Assoc J2007，9，11： | 1 |
| 3 | A semantic analysis of addition and subtraction word problems in arithmetic显示文摘 | Pearla Nesher Tamar Katriel | 1977 | Educational Studies in Mathematics1977，，3： | 1 |
| 4 | lmprovedbeta cellfu notion 16afterintensiveinsulintreatmentinseverenon insulin- dependentdiabetes显示文摘 | Glaser B Leibovich G Nesher R | 1988 | ActaEndocrinol1988，118，： | 1 |
| 5 | The digitalis-like steroidhormones:new mechanisms of action and biological significance显示文摘 | Nesher M Shpolansky U Rosen H | 2007 | Life Sci2007，80，23： | 1 |
| 6 | Lupus associated panereatitis 显示文摘 | Nesher G Breuer GS TemPrano K | 2006 | Semin Arthritis Rheunl2006，35，4： | 1 |
| 7 | Rheumatoid arthritism in the elderly 显示文摘 | Nesher G Moore T Zuckner J | 1991 | J Am Geriatr SOC1991，39，： | 1 |
| 8 | High performance IR detectors at SCD present and future 显示文摘 | O Nesher P C Klipstein | 2006 | Opto-Electronics Review2006，14，1： | 1 |
| 9 | Strict thermoregulation attenuates myocardial injury during coronary artery bypass graft surgery as reflected by reduced levels of cardiac-specific troponin I显示文摘 | Nesher N Zisman E Wolf T | 2003 | Anesth Analg2003，96，2： | 1 |
| 10 | High Performance IR Detectors at SCD Present and Future显示文摘 | Nesher O Klipstein P C | 2006 | OptoElectronics Review2006，14，1： | 1 |
| 11 | Diffuse near-infrared reflectance spectroscopy during heatstroke in a mouse model:pilot study显示文摘 | Abookasis D Zafrir E Nesher E | 2012 | J Biomed Opt2012，17，10： | 1 |
| 12 | Anti-nuclear envelope anti-bodies :Clinical associations 显示文摘 | Nesher G Margalit R Ashkenazi YJ | 2001 | Semin Arthritis Rheum2001，30，5： | 1 |
| 13 | Low - dose ketamine via intravenous patient - controlled analgesia device after various transthoracic procedures improves analgesia and patient and family satisfaction 显示文摘 | CHAZAN S BUDA I NESHER N | 2010 | Pain Manag Nurs2010，11，3： | 1 |
| 14 | Morphine with adju- vant ketamine vs higher dose of morphine alone for immediate post-thoracotomy analgesia显示文摘 | NESHER N EKSTEIN M P PAZ Y | 2009 | Chest2009，136，1： | 1 |
| 15 | Ketamine spares morphine consumption after transthoracic lung and heart sur- gery without adverse hcmodynamic effects 显示文摘 | NESHER N SEROVIAN I MAROUANI N | 2008 | Pharmacol Res2008，58，1： | 1 |
| 16 | Strict thermoregnlation attenuates myocardial injury during coronary artery bypass graft surgery as refleeted by reduced levels of cardiac-specific tmponin I 显示文摘 | Nesher N Zisman E Wolf T | 2003 | Anesth Analg2003，96，2： | 1 |
| 17 | Cytomegalovirusdiseases after hematopoietic stem cell transplantation: A mini-review显示文摘 | Ariza-Heredia EJ Nesher L Chemaly RF | 2014 | Cancer Lett2014，342，1： | 1 |
| 18 | Lu pus associated panereatitis显示文摘 | Nesher G Breuer GS TemPrano K | 2006 | Semin Arthritis Rheunl2006，35，4： | 1 |
| 19 | Thermo - wrap technology preserves normothermia better than routine thermal care in patients undergoing off - pump coronary artery bypass and is associated with lower immune response and lesser myocardial damage 显示文摘 | Nesher N Uretzky G Insler S | 2005 | J Thorac Cardiovasc Surg2005，129，6： | 1 |
| 20 | A new thermoregulation system for maintaining perioperativenormothermia and attenuating myocardial injury in off-pump coronary artery bypass surgery 显示文摘 | Nesher N Insler S R Sheinberg N | 2002 | Heart Surg Forum2002，5，4： | 1 |
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