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Effects of Chemotherapy in Patients with Concomitant Aortic Aneurysm and Malignant Disease

Ann Vasc Surg. 2017 Nov:45:268.e13-268.e20. doi: 10.1016/j.avsg.2017.07.013. Epub 2017 Jul 21.

Abstract

Background: The aim of the study is to present the results in a consecutive series of patients affected by aortic abdominal aneurysm and to underline the aneurysmal growth and evolution in oncological patients submitted to dedicated oncological medical therapy.

Methods: Between January 2010 and June 2016 we treated in our center 19 patients for coexisting aortic aneurysms (>3 cm) and malignancy. We observed patients undergoing oncological treatment and patients who did not undergo medical treatment. We studied computed tomography (CT) scan at the time when patients were addressed at our follow-up or treatment and we analyzed retrospectively prior CT scan at 6 and 12 months.

Results: Among those 19 patients, 7 patients were affected by colorectal cancer (36.8%), 6 by urinary tract cancer (31.6%), 4 by lymphoma (21%), and 2 by lung cancer (10.6%). In 8 patients who did not undergo oncological therapy, we did not observe any aortic growth; instead, in other 4 patients who underwent oncological medical therapy (3 abdominal aortic aneurysms and 1 thoracic aneurysm), we observed a mean sac growth of 2.9 cm in 6 months with 2 cases of aortic rupture treated in urgent fashion. The treatment was open surgery in 2 cases and endovascular in other cases.

Conclusions: We observed that oncological drugs may play a role in aneurysm growth. Few case reports are found in the literature and more evidences are to be found. Those information may influence intention-to-treat small aneurysms in short life expectancy patients.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Aortic Aneurysm, Abdominal / complications*
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / surgery
  • Aortic Aneurysm, Thoracic / complications*
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / surgery
  • Aortography / methods
  • Blood Vessel Prosthesis Implantation
  • Clinical Decision-Making
  • Computed Tomography Angiography
  • Disease Progression
  • Endovascular Procedures
  • Female
  • Humans
  • Iliac Aneurysm / complications*
  • Iliac Aneurysm / diagnostic imaging
  • Iliac Aneurysm / surgery
  • Life Expectancy
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / diagnosis
  • Neoplasms / drug therapy*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome

Substances

  • Antineoplastic Agents