Influence of a History of Malignancy on the Long-Term Survival of Abdominal Aortic Aneurysm Patients with Indication for an Elective Repair

Autores de IIS La Fe

• Manuel Miralles Hernández

  Autor

Participantes ajenos a IIS La Fe

• Arpa A.
• Abadal M.
• Navarro N.
• Elosua R.
• Clara A.

Grupos

• Hemostasia, Trombosis, Arteriosclerosis y Biología vascular

Abstract

Background: The elective repair of aorto-iliac aneurysms (AAAs) 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, such as 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, and 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 nonadvanced urological cancer had similar survival than those without cancer, while only those with an advanced cancer (metastasis or palliative care) or a currently treated nonurological solid tumor had lower life expectancy (hazard ratio = 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. Conclusion: 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 nonurological cancer had lower survival rates, so in these cases AAA decision-making should be individualized. © 2025 Elsevier Inc.

Keywords

• Aged; Aged, 80 and over; Aortic Aneurysm, Abdominal; Blood Vessel Prosthesis Implantation; Comorbidity; Elective Surgical Procedures; Female; Humans; Life Expectancy; Male; Middle Aged; Neoplasms; Retrospective Studies; Risk Assessment; Risk Factors; Time Factors; Treatment Outcome; Vascular Surgical Procedures; abdominal aortic aneurysm; advanced cancer; age distribution; aged; aneurysm surgery; aortoiliac aneurysm; Article; bone cancer; breast cancer; cancer localization; cancer palliative therapy; cancer therapy; case study; Charlson Comorbidity Index; clinical feature; controlled study; correlation analysis; digestive system cancer; elective surgery; female; follow up; human; iliac artery aneurysm; life expectancy; long term survival; major clinical study; male; medical history; metastasis; proportional hazards model; respiratory tract cancer; retrospective study; sex difference; solid malignant neoplasm; survival rate; tertiary care center; thyroid cancer; treatment indication; ur