Management of Concomitant Cancer and Abdominal Aortic Aneurysm

Table 3

Reference (first author)	Type of cancer	No. of cases	Group	Approach	AAA rupture rate (period)	Interval between AA repair and cancer treatment	Delay in cancer treatment	Cancer outcome	Graft complication rate	% mortality rate (mode)
	CRC	83 (of 435 AAA pts over 8 yrs)	One: 44pts	CRC treated first. AAA average size 3.8 cm	1/44 ruptured (7yrs later) 1/44 died of sepsis following repair of AAA (1 yr later)		4 days	13% recurrence		4.5% (30 d)
Baxter et al. [11]			Two: 20pts	CRC treated first. AAA average size 5.4 cm	2/20 (10%) had rAAA postoperatively. 1 died		8 days	33% recurrence		10% (30 d)
			Three: 12pts	AAA and CRC treated simultaneously. AAA average size 6.4 cm	0%		15 days	17% recurrence		14% (30 d)
			Four: 7pts	AAA treated first. AAA average size 6 cm	0%		122 days	9% recurrence		8% (30 d)
	Different types; (urinary tract, GI, and lung)	25	One: 11	EVAR performed first. AAA average size 5.9 cm		6.5 days (average)			2/11 graft occlusion—0/11 infection	0% (periop)
Porcellini et al. [27]			Two: 7	Open surgery performed first. AAA average size 6.8 cm	0	34 days		3 died of mets (11, 15, and 39 mo)	1/14 graft infection	3/14 died after AAA repair
			Three: 6	One-stage operation	0	0		1 died of mets (15 mo)		0%
			Four: 1	Cancer first	1	82 d		alive (55 mo)	0	0%
	CRC	7	Open: 5	AAA and CRC treated simultaneously. AAA average size?	0		NS	NS	0%
Herald et al. [28]			EVAR: 1	AAA and CRC treated simultaneously. AAA average size NS	0	0	NS	Alive (12 months)	0%
			EVAR: 1	AAA before the CRC. AAA average size NS	0	14	NS	Alive (6 months)	0%
Chai et al. [29]	CRC	2		EVAR followed by CRC resection	0	7	NS	Alive (12 months)	100% (graft occlusion). Case report type
Sheen et al. [30]	Pancreas	1		EVAR followed by pancreatectomy	0	9	NS	Alive (1 month)	0%
	Renal	27	11	One stage	0	0		80% survival	0 (57months)
Hafez et al. [31]			13	AAA first	0	?		35% survival	0 (57months)
			3	Renal malignancy first	0	?		80% survival	0 (57months)
				different grouping
Matsumoto; et al. [10, 32]	Gastric and; colorectal cancer	25 (out of 186 AAA repairs) - high risk pts only included	Group 1: 14	One-stage operation	0		NA	2 died of renal failure (10 mo) or mets (2yrs)	NA	0; (Periop)
			Group 2: 11	Two-stage operation	0		NA	1 died of Mi (3 mo)	NA	0; (Periop)
	CRC	108	Group 1: 46	CRC treated first. AAA second: group A: 35 open/group B: 11 EVAR		A: 42 d/B: 35			2/11 (Group B) had sigmoid ischaemia
Lin et al. [33]			Group 2: 38	AAA first: Group C: 26 open/ Group D: 12 EVAR			C: 115/ D: 12	Significant periop morbidity/mortality in Group C
			Group 3: 8	Combined
	All (mostly CRC)	7 (127 AAAs)	Group 1: 3	One stage					0%
Suffat et al. [34]			Group 2: 1	Two stage (?)					0%
			Group 3: 3	EVAR			Few days		0%
	gastric	6 (222 AAAs)	Group 1: 3	CRC first (advanced cancer)				71% alive at 4 yrs
Komori et al. [35]			Grorp 2: 1	AAA first (>6 cm)
			Group 3: 2	One stage
	CRC	13	Group 1: 10	CRC first; Open AAA (3) or EVAR (7) second	0				0
Shalhoub et al. [36]			Group 2: 2	AAA first (diameter 7&8 cm)	0				0
			Group 3: 1		0				0
Oshodi et al. [8]	All	56 (676)		One-stage open surgery	3 deaths/ 7 early reoperation	0			0	0; (Periop)
Galt et al. [37]	renal	10		One stage	0	0	NS	1 died from mets	0
Veraldi et al. [38]	CRC	14	Group 1: 9	One stage	0	0		NA	0 (up to 5yrs)	0; (Periop)
			Group 2: 7	Two stage	0	31 d		NA

*AAA: abdominal aortic aneurysm. CRC: colorectal cancer. GI: Gastrointestinal. NS: not specified. NA: not applicable/not provided. EVAR: endovascular aneurysm repair.