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Erschienen in: Surgery Today 8/2016

15.10.2015 | Original Article

Current surgical management of abdominal aortic aneurysm with concomitant malignancy in the endovascular era

verfasst von: Koji Maeda, Takao Ohki, Yuji Kanaoka, Naoki Toya, Takeshi Baba, Masayuki Hara, Shin Hagiwara

Erschienen in: Surgery Today | Ausgabe 8/2016

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Abstract

Purpose

The management of abdominal aortic aneurysm (AAA) with concomitant malignancy is controversial in terms of which treatment should come first. The aim of this study was to evaluate the outcomes of endovascular aortic repair (EVAR) as the initial treatment prior to the treatment of malignancy for patients with AAA and concomitant malignancy.

Methods

EVAR for AAA was performed in 1,175 cases between April 2007 and April 2014, of which 63 patients (5.4 %) who had AAAs and malignancy were identified. The clinical details and outcomes for patients with AAA and malignancy were evaluated.

Results

The mean age of patients with AAA and malignancy was 76.6 years. Thirty-three patients underwent EVAR before surgery for their malignancies, and 30 patients received chemoradiotherapy following EVAR. No significant differences in the length of stay (LOS), 30-day mortality, and morbidities were observed in all groups. However, the overall survival rate of the patients who had AAA and malignancy was lower than those who had only AAA (P < 0.0001). The mean intervals from EVAR to surgery and chemoradiotherapy for malignancy in our institution were 13.4 days (overall 38.1 days) and 5.8 days (overall 18.2 days), respectively.

Conclusion

EVAR for patients with AAA and concomitant malignancy may be acceptable in terms of a short LOS and resulting in treatment for malignancy without delay.
Literatur
1.
Zurück zum Zitat Szilagyi DE, Elliott JP, Berguer R. Coincidental malignancy and abdominal aortic aneurysm. Arch Surg. 1967;95:402–12.CrossRefPubMed Szilagyi DE, Elliott JP, Berguer R. Coincidental malignancy and abdominal aortic aneurysm. Arch Surg. 1967;95:402–12.CrossRefPubMed
2.
Zurück zum Zitat Porcellini M, Nastro P, Bracale U, Brearley S, Giordano P. Endovascular versus open surgical repair of abdominal aortic aneurysm with concomitant malignancy. J Vasc Surg. 2007;46:16–23.CrossRefPubMed Porcellini M, Nastro P, Bracale U, Brearley S, Giordano P. Endovascular versus open surgical repair of abdominal aortic aneurysm with concomitant malignancy. J Vasc Surg. 2007;46:16–23.CrossRefPubMed
3.
Zurück zum Zitat Shalhoub J, Naughton P, Lau N, Tsang JS, Kelly CJ, Leahy AL, et al. Concurrent colorectal malignancy and abdominal aneurysm: a multicentre experience and review of the literature. Eur J Endovasc Surg. 2009;37:544–6.CrossRef Shalhoub J, Naughton P, Lau N, Tsang JS, Kelly CJ, Leahy AL, et al. Concurrent colorectal malignancy and abdominal aneurysm: a multicentre experience and review of the literature. Eur J Endovasc Surg. 2009;37:544–6.CrossRef
4.
Zurück zum Zitat Matsumoto K, Nakamura M, Obara H, Hayashi S, Harada H, Kitajima M, et al. Surgical strategy for abdominal aortic aneurysm with concurrent symptomatic malignancy. World J Surg. 1999;23:248–51.CrossRefPubMed Matsumoto K, Nakamura M, Obara H, Hayashi S, Harada H, Kitajima M, et al. Surgical strategy for abdominal aortic aneurysm with concurrent symptomatic malignancy. World J Surg. 1999;23:248–51.CrossRefPubMed
5.
Zurück zum Zitat Lin PH, Barshes NR, Albo D, Kougias P, Berger DH, Huynh TT, et al. Concomitant colorectal cancer and abdominal aortic aneurysm: evolution of treatment paradigm in endovascular era. J Am Coll Surg. 2008;206:1065–73.CrossRefPubMed Lin PH, Barshes NR, Albo D, Kougias P, Berger DH, Huynh TT, et al. Concomitant colorectal cancer and abdominal aortic aneurysm: evolution of treatment paradigm in endovascular era. J Am Coll Surg. 2008;206:1065–73.CrossRefPubMed
6.
Zurück zum Zitat Jabawi A, Ahmed I, El-Sakka K, Yusuf SW. Management of concomitant cancer and abdominal aortic aneurysm. Cadiol Res Pract. 2011;19:516146. Jabawi A, Ahmed I, El-Sakka K, Yusuf SW. Management of concomitant cancer and abdominal aortic aneurysm. Cadiol Res Pract. 2011;19:516146.
7.
Zurück zum Zitat Morris HL, Da Silva AF. Co-existing abdominal aortic aneurysm and intra-abdominal malignancy: reflections on the order of treatment. Br J Surg. 1998;85:1185–90.CrossRefPubMed Morris HL, Da Silva AF. Co-existing abdominal aortic aneurysm and intra-abdominal malignancy: reflections on the order of treatment. Br J Surg. 1998;85:1185–90.CrossRefPubMed
8.
Zurück zum Zitat Lobbato VJ, Rorthenberg RE, LaRaja RD, Georgiou J. Coexsistence of abdominal aortic aneurysm and carcinoma of the colon: a dilemma. J Vasc Surg. 1985;2:724–6.CrossRefPubMed Lobbato VJ, Rorthenberg RE, LaRaja RD, Georgiou J. Coexsistence of abdominal aortic aneurysm and carcinoma of the colon: a dilemma. J Vasc Surg. 1985;2:724–6.CrossRefPubMed
9.
Zurück zum Zitat Nora JD, Pairolero PC, Nivatvongs S, Cherry KJ, Hallet JW, Gloviczki P. Concomitant abdominal aortic aneurysm and colorectal carcinoma: priority of resection. J Vasc Surg. 1989;9:630–6.CrossRefPubMed Nora JD, Pairolero PC, Nivatvongs S, Cherry KJ, Hallet JW, Gloviczki P. Concomitant abdominal aortic aneurysm and colorectal carcinoma: priority of resection. J Vasc Surg. 1989;9:630–6.CrossRefPubMed
10.
Zurück zum Zitat Shimada Y, Sogawa M, Okada A. A single-staged operation for abdominal aortic aneurysm with concomitant colorectal carcinoma. Ann Thorac Cardiovasc Surg. 2005;11:339–42.PubMed Shimada Y, Sogawa M, Okada A. A single-staged operation for abdominal aortic aneurysm with concomitant colorectal carcinoma. Ann Thorac Cardiovasc Surg. 2005;11:339–42.PubMed
11.
Zurück zum Zitat Kurata S, Nawata K, Nawata S, Namura O, Hayashi J, Iiai T, et al. Surgery for abdominal aortic aneurysm associated with malignancy. Surg Today. 1998;28:895–9.CrossRefPubMed Kurata S, Nawata K, Nawata S, Namura O, Hayashi J, Iiai T, et al. Surgery for abdominal aortic aneurysm associated with malignancy. Surg Today. 1998;28:895–9.CrossRefPubMed
12.
Zurück zum Zitat Komori K, Okadome K, Odashiro T, Ishii T, Itoh H, Funahashi S, et al. Simultaneous resection of abdominal aortic aneurysms and early gastric cancer by retroperitoneal and transperitoneal approach. Eur J Vasc. 1992;6:639–41.CrossRef Komori K, Okadome K, Odashiro T, Ishii T, Itoh H, Funahashi S, et al. Simultaneous resection of abdominal aortic aneurysms and early gastric cancer by retroperitoneal and transperitoneal approach. Eur J Vasc. 1992;6:639–41.CrossRef
13.
Zurück zum Zitat Hafez KS, Fettouh EL, Novick AC, Ouriel K. Management of synchronous renal neoplasm and abdominal aortic aneurysm. J Vasc Surg. 2000;12:1102–10.CrossRef Hafez KS, Fettouh EL, Novick AC, Ouriel K. Management of synchronous renal neoplasm and abdominal aortic aneurysm. J Vasc Surg. 2000;12:1102–10.CrossRef
14.
Zurück zum Zitat Verardi GF, Tasselli S, De Manzoni G, Cordiano C. Surgical treatment of abdominal aortic aneurysm with concomitant renal cell carcinoma: a single- centre experience with review of literature. J Cardiovasc Surg (Torino). 2006;53:973–5. Verardi GF, Tasselli S, De Manzoni G, Cordiano C. Surgical treatment of abdominal aortic aneurysm with concomitant renal cell carcinoma: a single- centre experience with review of literature. J Cardiovasc Surg (Torino). 2006;53:973–5.
15.
Zurück zum Zitat Borzellino G, Giovinazzo F, Minicozzi AM, Dusui R, Politi L, Veraldi GF. Concomitant pulmonary carcinoma and abdominal aortic aneurysm: therapeutic strategies. Surg Today. 2008;38:512–6.CrossRefPubMed Borzellino G, Giovinazzo F, Minicozzi AM, Dusui R, Politi L, Veraldi GF. Concomitant pulmonary carcinoma and abdominal aortic aneurysm: therapeutic strategies. Surg Today. 2008;38:512–6.CrossRefPubMed
16.
Zurück zum Zitat Blochle R, Lall P, Cherr GS, Harris LM, Dryjski ML, Hsu HK, et al. Management of patients with concomitant lung cancer and abdominal aortic aneurysm. Am J Surg. 2008;196:697–702.CrossRefPubMed Blochle R, Lall P, Cherr GS, Harris LM, Dryjski ML, Hsu HK, et al. Management of patients with concomitant lung cancer and abdominal aortic aneurysm. Am J Surg. 2008;196:697–702.CrossRefPubMed
17.
Zurück zum Zitat Galt SW, McCarthy WJ, Pearce WH, Carter MF, Dalton DP, Garmett JE, et al. Simultaneous abdominal aortic aneurysm repair and nephrectomy for neoplasm. Am J Surg. 1995;170:227–30.CrossRefPubMed Galt SW, McCarthy WJ, Pearce WH, Carter MF, Dalton DP, Garmett JE, et al. Simultaneous abdominal aortic aneurysm repair and nephrectomy for neoplasm. Am J Surg. 1995;170:227–30.CrossRefPubMed
18.
Zurück zum Zitat Swanson RJ, Littooy FN, Hunt TK, Stoney RJ. Laparotomy as a precipitating factor in the rupture of intra-abdominal aneurysm. Arch Surg. 1980;115:299–304.CrossRefPubMed Swanson RJ, Littooy FN, Hunt TK, Stoney RJ. Laparotomy as a precipitating factor in the rupture of intra-abdominal aneurysm. Arch Surg. 1980;115:299–304.CrossRefPubMed
19.
Zurück zum Zitat Baxter NN, Noel AA, Cherry K, Wolff BG. Management of patients with colorectal cancer and concomitant abdominal aortic aneurysm. Dis Colon Rectum. 2002;45:165–70.CrossRefPubMed Baxter NN, Noel AA, Cherry K, Wolff BG. Management of patients with colorectal cancer and concomitant abdominal aortic aneurysm. Dis Colon Rectum. 2002;45:165–70.CrossRefPubMed
20.
Zurück zum Zitat Grego F, Lepidi S, Bassi P, Tavolini IM, Noventa F, Pagano F, et al. Simultaneous surgical treatment of abdominal aortic aneurysm and carcinoma of the bladder. J Vasc Surg. 2003;37:607–14.CrossRefPubMed Grego F, Lepidi S, Bassi P, Tavolini IM, Noventa F, Pagano F, et al. Simultaneous surgical treatment of abdominal aortic aneurysm and carcinoma of the bladder. J Vasc Surg. 2003;37:607–14.CrossRefPubMed
21.
Zurück zum Zitat Robinson G, Hughes W, Lippey E. Abdominal aortic aneurysm and associated colorectal carcinoma: a management problem. Aust N Z J Surg. 1994;64:475–8.CrossRefPubMed Robinson G, Hughes W, Lippey E. Abdominal aortic aneurysm and associated colorectal carcinoma: a management problem. Aust N Z J Surg. 1994;64:475–8.CrossRefPubMed
22.
Zurück zum Zitat Trueblood HW, Williams DK, Gustafson JR. Aneurysmal rupture following resection of abdominal malignancy. Am Surg. 1976;42:535–7.PubMed Trueblood HW, Williams DK, Gustafson JR. Aneurysmal rupture following resection of abdominal malignancy. Am Surg. 1976;42:535–7.PubMed
23.
Zurück zum Zitat Ochsner JL, Cooley DA, De Bakey ME. Associated intra-abdominal lesions encountered during resection of aortic aneurysms. Surgical considerations. Dis colon Rectum. 1960;3:485–90.CrossRefPubMed Ochsner JL, Cooley DA, De Bakey ME. Associated intra-abdominal lesions encountered during resection of aortic aneurysms. Surgical considerations. Dis colon Rectum. 1960;3:485–90.CrossRefPubMed
24.
Zurück zum Zitat EVAR trial participants. Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm (EVAR 1 trial): randomized controlled trial. Lancet. 2005;365:2179–86.CrossRef EVAR trial participants. Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm (EVAR 1 trial): randomized controlled trial. Lancet. 2005;365:2179–86.CrossRef
25.
Zurück zum Zitat Gleenhalgh RM, Brown LC, Powell JT, Thompson SG, Epstein D, Sculpher MJ, United Kingdom EVAR Trial investigators. Endovascular versus open repair of abdominal aortic aneurysm. N Eng J Med. 2010;362:1863–71.CrossRef Gleenhalgh RM, Brown LC, Powell JT, Thompson SG, Epstein D, Sculpher MJ, United Kingdom EVAR Trial investigators. Endovascular versus open repair of abdominal aortic aneurysm. N Eng J Med. 2010;362:1863–71.CrossRef
26.
Zurück zum Zitat Thomas DM, Hulten EA, Ellis ST, Anderson DM, Anderson N, McRae F, et al. Open versus endovascular repair of abdominal aortic aneurysm in the elective and emergent setting in a pooled population of 37,781 patients: a systematic review and meta-analysis. ISRN Cardiol. 2014;1–9. Article ID 149243. doi:10.1155/2014/149243 Thomas DM, Hulten EA, Ellis ST, Anderson DM, Anderson N, McRae F, et al. Open versus endovascular repair of abdominal aortic aneurysm in the elective and emergent setting in a pooled population of 37,781 patients: a systematic review and meta-analysis. ISRN Cardiol. 2014;1–9. Article ID 149243. doi:10.​1155/​2014/​149243
27.
Zurück zum Zitat Coughlin PA, Jackson D, White AD, Bailey MA, Farrow C, Scott DJA, et al. Meta-analysis of prospective trials determining the short- and mid-term effect of elective open and endovascular repair of abdominal aortic aneurysms on quality of life. Br J Surg. 2013;100:448–55.CrossRefPubMed Coughlin PA, Jackson D, White AD, Bailey MA, Farrow C, Scott DJA, et al. Meta-analysis of prospective trials determining the short- and mid-term effect of elective open and endovascular repair of abdominal aortic aneurysms on quality of life. Br J Surg. 2013;100:448–55.CrossRefPubMed
28.
Zurück zum Zitat Stather PW, Sidoloff D, Dattani N, Choke E, Brown MJ, Sayers RD. Systematic review and meta-analysis of early and late outcomes of open and endovascular repair of abdominal aortic aneurysm. Br J Surg. 2013;100:863–72.CrossRefPubMed Stather PW, Sidoloff D, Dattani N, Choke E, Brown MJ, Sayers RD. Systematic review and meta-analysis of early and late outcomes of open and endovascular repair of abdominal aortic aneurysm. Br J Surg. 2013;100:863–72.CrossRefPubMed
29.
Zurück zum Zitat Matsumoto T, Tanaka S, Okadome J, Kyuragi R, Fukunaga R, Kawakubo E, et al. Midterm outcomes of endovascular repair for abdominal aortic aneurysms with the on-label use compared with the off-label use of an endoprosthesis. Surg Today. 2015;45:880–5.CrossRefPubMed Matsumoto T, Tanaka S, Okadome J, Kyuragi R, Fukunaga R, Kawakubo E, et al. Midterm outcomes of endovascular repair for abdominal aortic aneurysms with the on-label use compared with the off-label use of an endoprosthesis. Surg Today. 2015;45:880–5.CrossRefPubMed
30.
Zurück zum Zitat Ishibashi H, Ishiguchi T, Ohta T, Sugimoto I, Iwata H, Yamada T, et al. Late events and mid-term results after endovascular aneurysm repair. Surg Today. 2014;44:50–4.CrossRefPubMed Ishibashi H, Ishiguchi T, Ohta T, Sugimoto I, Iwata H, Yamada T, et al. Late events and mid-term results after endovascular aneurysm repair. Surg Today. 2014;44:50–4.CrossRefPubMed
31.
Zurück zum Zitat Lujan J, Valeno G, Hernandez Q, Sanchez A, Frutos MD, Parrilla P. Randomized clinical trial comparing laparoscopic and open surgery in patients with rectal cancer. Br J Surg. 2009;96:982–9.CrossRefPubMed Lujan J, Valeno G, Hernandez Q, Sanchez A, Frutos MD, Parrilla P. Randomized clinical trial comparing laparoscopic and open surgery in patients with rectal cancer. Br J Surg. 2009;96:982–9.CrossRefPubMed
32.
Zurück zum Zitat Fleshman J, Srgent DJ, Green E, Anvari M, Stryker SJ, Beart RB Jr, et al. Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST study group trial. Ann Surg. 2007;246:655–64.CrossRefPubMed Fleshman J, Srgent DJ, Green E, Anvari M, Stryker SJ, Beart RB Jr, et al. Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST study group trial. Ann Surg. 2007;246:655–64.CrossRefPubMed
33.
Zurück zum Zitat Tanimura S, Higashino M, Fukunaga Y, Takemura M, Tanaka Y, Fujiwara Y, et al. Laparoscopic gastrectomy for gastric cancer: experience with more than 600 cases. Surg Endosc. 2008;22:1161–4.CrossRefPubMed Tanimura S, Higashino M, Fukunaga Y, Takemura M, Tanaka Y, Fujiwara Y, et al. Laparoscopic gastrectomy for gastric cancer: experience with more than 600 cases. Surg Endosc. 2008;22:1161–4.CrossRefPubMed
34.
Zurück zum Zitat Fujiwara M, Kodera Y, Miura S, Kanyama Y, Yokoyama H, Ohashi N, et al. Laparoscopy-assisted distal gastrectomy with systemic lymph node dissection: a phase II study following the learning curve. J Surg Oncol. 2005;91:26–32.CrossRefPubMed Fujiwara M, Kodera Y, Miura S, Kanyama Y, Yokoyama H, Ohashi N, et al. Laparoscopy-assisted distal gastrectomy with systemic lymph node dissection: a phase II study following the learning curve. J Surg Oncol. 2005;91:26–32.CrossRefPubMed
35.
Zurück zum Zitat Palm SJ, Russwurm GP, Chang D, Rozenblit AM, Ohki T, Veith FJ. Acute enlargement and subsequent rupture of an abdominal aortic aneurysm in a patient receiving chemotherapy for pancreatic carcinoma. J Vasc Surg. 2000;32:197–200.CrossRefPubMed Palm SJ, Russwurm GP, Chang D, Rozenblit AM, Ohki T, Veith FJ. Acute enlargement and subsequent rupture of an abdominal aortic aneurysm in a patient receiving chemotherapy for pancreatic carcinoma. J Vasc Surg. 2000;32:197–200.CrossRefPubMed
36.
Zurück zum Zitat Lauro S, Lanzetta G, Baria E, Trasatti L, Gelibter A, Vecchione A. Antiblastic chemotherapy in the presence of abdominal aorta aneurysm (AAA): guidelines. Anticancer Res. 1999;2B:1439–44. Lauro S, Lanzetta G, Baria E, Trasatti L, Gelibter A, Vecchione A. Antiblastic chemotherapy in the presence of abdominal aorta aneurysm (AAA): guidelines. Anticancer Res. 1999;2B:1439–44.
37.
Zurück zum Zitat Mallioux A, Grenet K, Bruneel A, Beneteau-Bumat B, Vaubourdolle M, Baudin B. Anticancer drugs induce necrosis of human endothelial cells involving both oncosis and apoptosis. Eur J Cell Biol. 2001;80:442–9.CrossRef Mallioux A, Grenet K, Bruneel A, Beneteau-Bumat B, Vaubourdolle M, Baudin B. Anticancer drugs induce necrosis of human endothelial cells involving both oncosis and apoptosis. Eur J Cell Biol. 2001;80:442–9.CrossRef
38.
Zurück zum Zitat Seqelov E, Chan D, Shapiro J, Price TJ, Karapetis CS, Tebbutt NC, et al. The role of biological therapy in metastatic colorectal cancer after first-line treatment; a meta-analysis of randomized trials. Br J Cancer. 2014;6:1122–31.CrossRef Seqelov E, Chan D, Shapiro J, Price TJ, Karapetis CS, Tebbutt NC, et al. The role of biological therapy in metastatic colorectal cancer after first-line treatment; a meta-analysis of randomized trials. Br J Cancer. 2014;6:1122–31.CrossRef
Metadaten
Titel
Current surgical management of abdominal aortic aneurysm with concomitant malignancy in the endovascular era
verfasst von
Koji Maeda
Takao Ohki
Yuji Kanaoka
Naoki Toya
Takeshi Baba
Masayuki Hara
Shin Hagiwara
Publikationsdatum
15.10.2015
Verlag
Springer Japan
Erschienen in
Surgery Today / Ausgabe 8/2016
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-015-1262-8

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