Abdominal Aortic Aneurysm Repair in Patients with Concomitant Cancer: A Literature Review

Anne C. Nielsen; Chalotte W. Nicolajsen; Nikolaj Eldrup

doi:10.1177/17085381231159151

Abdominal Aortic Aneurysm Repair in Patients with Concomitant Cancer: A Literature Review

Anne C. Nielsen^*, Chalotte W. Nicolajsen, Nikolaj Eldrup

^*Corresponding author for this work

Department of Clinical Medicine - Karkirurgi, Viborg

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Review › Research › peer-review

Abstract

Objectives: Abdominal aortic aneurysmal (AAA) repair in patients with concomitant cancer is controversial due to increased comorbidity and reduced life expectancy in this specific patient group. This literature review aims to investigate the evidence supporting one treatment modality over another (endovascular aortic repair (EVAR) or open repair (OR)), as well as treatment strategy (staged AAA-, cancer first or simultaneous procedures) in patients with AAA and concomitant cancer. Methods: Literature review, including studies published from 2000 to 2021 on surgical treatment in patients with AAA and concomitant cancer and related outcomes (30-day morbidity/complications as well as 30-day and 3-year mortality). Results: 24 studies comprising 560 patients undergoing surgical treatment of AAA and concomitant cancer were included. Of these, 220 cases were treated with EVAR and 340 with OR. Simultaneous procedures were performed in 190 cases, 370 received staged procedures. The 30-day mortality for EVAR versus OR was 1% and 8%, corresponding to a relative risk (RR) of 0.11 (95% CI: 0.03–0.46, p = 0.002). No difference in mortality was observed between staged versus simultaneous procedure nor between AAA-first versus cancer-first strategy, RR 0.59 (95% CI: 0.29–1.1, p = 0.13) and 0.88 (95% CI 0.34–2.31, p = 0.80), respectively. Overall, 3-year mortality was 21% for EVAR and 39% for OR from 2000–2021, while the mortality up to 3 years after EVAR within recent years (2015–2021) was 16%. Conclusion: This review supports EVAR treatment as first choice if suitable. No consensus was established on treating either the aneurysm or the cancer first or simultaneously. Long-term mortality after EVAR was comparable to non-cancer patients within recent years.

Original language	English
Journal	Vascular
Volume	32
Issue	4
Pages (from-to)	717-727
ISSN	1708-5381
DOIs	https://doi.org/10.1177/17085381231159151
Publication status	Published - Aug 2024

Keywords

Abdominal aortic aneurysm
long-term results
malignancy
short-term results
surgical procedures

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10.1177/17085381231159151

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title = "Abdominal Aortic Aneurysm Repair in Patients with Concomitant Cancer: A Literature Review",

abstract = "Objectives: Abdominal aortic aneurysmal (AAA) repair in patients with concomitant cancer is controversial due to increased comorbidity and reduced life expectancy in this specific patient group. This literature review aims to investigate the evidence supporting one treatment modality over another (endovascular aortic repair (EVAR) or open repair (OR)), as well as treatment strategy (staged AAA-, cancer first or simultaneous procedures) in patients with AAA and concomitant cancer. Methods: Literature review, including studies published from 2000 to 2021 on surgical treatment in patients with AAA and concomitant cancer and related outcomes (30-day morbidity/complications as well as 30-day and 3-year mortality). Results: 24 studies comprising 560 patients undergoing surgical treatment of AAA and concomitant cancer were included. Of these, 220 cases were treated with EVAR and 340 with OR. Simultaneous procedures were performed in 190 cases, 370 received staged procedures. The 30-day mortality for EVAR versus OR was 1% and 8%, corresponding to a relative risk (RR) of 0.11 (95% CI: 0.03–0.46, p = 0.002). No difference in mortality was observed between staged versus simultaneous procedure nor between AAA-first versus cancer-first strategy, RR 0.59 (95% CI: 0.29–1.1, p = 0.13) and 0.88 (95% CI 0.34–2.31, p = 0.80), respectively. Overall, 3-year mortality was 21% for EVAR and 39% for OR from 2000–2021, while the mortality up to 3 years after EVAR within recent years (2015–2021) was 16%. Conclusion: This review supports EVAR treatment as first choice if suitable. No consensus was established on treating either the aneurysm or the cancer first or simultaneously. Long-term mortality after EVAR was comparable to non-cancer patients within recent years.",

keywords = "Abdominal aortic aneurysm, long-term results, malignancy, short-term results, surgical procedures",

author = "Nielsen, {Anne C.} and Nicolajsen, {Chalotte W.} and Nikolaj Eldrup",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2023.",

year = "2024",

month = aug,

doi = "10.1177/17085381231159151",

language = "English",

volume = "32",

pages = "717--727",

journal = "Vascular",

issn = "1708-5381",

publisher = "SAGE Publications Ltd",

number = "4",

}

TY - JOUR

T1 - Abdominal Aortic Aneurysm Repair in Patients with Concomitant Cancer

T2 - A Literature Review

AU - Nielsen, Anne C.

AU - Nicolajsen, Chalotte W.

AU - Eldrup, Nikolaj

N1 - Publisher Copyright: © The Author(s) 2023.

PY - 2024/8

Y1 - 2024/8

N2 - Objectives: Abdominal aortic aneurysmal (AAA) repair in patients with concomitant cancer is controversial due to increased comorbidity and reduced life expectancy in this specific patient group. This literature review aims to investigate the evidence supporting one treatment modality over another (endovascular aortic repair (EVAR) or open repair (OR)), as well as treatment strategy (staged AAA-, cancer first or simultaneous procedures) in patients with AAA and concomitant cancer. Methods: Literature review, including studies published from 2000 to 2021 on surgical treatment in patients with AAA and concomitant cancer and related outcomes (30-day morbidity/complications as well as 30-day and 3-year mortality). Results: 24 studies comprising 560 patients undergoing surgical treatment of AAA and concomitant cancer were included. Of these, 220 cases were treated with EVAR and 340 with OR. Simultaneous procedures were performed in 190 cases, 370 received staged procedures. The 30-day mortality for EVAR versus OR was 1% and 8%, corresponding to a relative risk (RR) of 0.11 (95% CI: 0.03–0.46, p = 0.002). No difference in mortality was observed between staged versus simultaneous procedure nor between AAA-first versus cancer-first strategy, RR 0.59 (95% CI: 0.29–1.1, p = 0.13) and 0.88 (95% CI 0.34–2.31, p = 0.80), respectively. Overall, 3-year mortality was 21% for EVAR and 39% for OR from 2000–2021, while the mortality up to 3 years after EVAR within recent years (2015–2021) was 16%. Conclusion: This review supports EVAR treatment as first choice if suitable. No consensus was established on treating either the aneurysm or the cancer first or simultaneously. Long-term mortality after EVAR was comparable to non-cancer patients within recent years.

AB - Objectives: Abdominal aortic aneurysmal (AAA) repair in patients with concomitant cancer is controversial due to increased comorbidity and reduced life expectancy in this specific patient group. This literature review aims to investigate the evidence supporting one treatment modality over another (endovascular aortic repair (EVAR) or open repair (OR)), as well as treatment strategy (staged AAA-, cancer first or simultaneous procedures) in patients with AAA and concomitant cancer. Methods: Literature review, including studies published from 2000 to 2021 on surgical treatment in patients with AAA and concomitant cancer and related outcomes (30-day morbidity/complications as well as 30-day and 3-year mortality). Results: 24 studies comprising 560 patients undergoing surgical treatment of AAA and concomitant cancer were included. Of these, 220 cases were treated with EVAR and 340 with OR. Simultaneous procedures were performed in 190 cases, 370 received staged procedures. The 30-day mortality for EVAR versus OR was 1% and 8%, corresponding to a relative risk (RR) of 0.11 (95% CI: 0.03–0.46, p = 0.002). No difference in mortality was observed between staged versus simultaneous procedure nor between AAA-first versus cancer-first strategy, RR 0.59 (95% CI: 0.29–1.1, p = 0.13) and 0.88 (95% CI 0.34–2.31, p = 0.80), respectively. Overall, 3-year mortality was 21% for EVAR and 39% for OR from 2000–2021, while the mortality up to 3 years after EVAR within recent years (2015–2021) was 16%. Conclusion: This review supports EVAR treatment as first choice if suitable. No consensus was established on treating either the aneurysm or the cancer first or simultaneously. Long-term mortality after EVAR was comparable to non-cancer patients within recent years.

KW - Abdominal aortic aneurysm

KW - long-term results

KW - malignancy

KW - short-term results

KW - surgical procedures

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U2 - 10.1177/17085381231159151

DO - 10.1177/17085381231159151

M3 - Review

C2 - 36812403

AN - SCOPUS:85148750816

SN - 1708-5381

VL - 32

SP - 717

EP - 727

JO - Vascular

JF - Vascular

IS - 4

ER -

Abdominal Aortic Aneurysm Repair in Patients with Concomitant Cancer: A Literature Review

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