Influence of a history of malignancy on the long-term survival of abdominal aortic aneurysm patients with indication for an elective repair.

Autors de IIS La Fe

• Manuel Miralles Hernández

  Autor

Autors aliens a IIS La Fe

• Arpa, Alina
• Abadal, Mar
• Navarro, Nil
• Elosua, Roberto
• Clara, Albert

Grups d'Investigació

• Hemostasia, Trombosis, Arteriosclerosis y Biología vascular

  

  Investigador Principal

  Pilar Medina Badenes

Abstract

BACKGROUND: The elective repair of aorto-iliac aneurysms (AAA) in patients with a cancer history is sometimes controversial. Our aim was to evaluate the relationship between the history of a solid tumor and the long-term survival of patients with an AAA within therapeutic range. METHODS: The consecutive series of patients with an intact AAA within therapeutic range attended in a tertiary hospital (2008-2021) was evaluated. Collected variables included clinical and cancer characteristics: time since treatment, location and extension. The association between cancer history and survival was evaluated with Cox models adjusted by age, sex, the Charlson comorbidity index and aneurysm treatment. RESULTS: The study included 416 patients (mean age 75.2 years; 92.2% male; 314 AAA electively treated). Among them, 117 had a history of a solid tumor (61 genitourinary, 30 digestive, 22 respiratory), 54 were active or treated <6 months, 12 had metastases, and 8 were under palliative care. During follow-up, 248 (59.6%) patients died. Patients with non-advanced urological cancer had similar survival than those without cancer, while only those with an advanced cancer (metastasis or palliative care) or a currently treated non-urological solid tumor had lower life expectancy (HR=1.84, p=0.04). All AAA patients, regardless their cancer history, had lower survival rates when compared with an age- and sex-matched population. CONCLUSIONS: Patients with AAA have a limited life expectancy and a prior cancer history does not commonly worsen their prognosis. Patients with an advanced or a current non-urological cancer had lower survival rates, so in these cases AAA decision-making should be individualized.