Abstract
PURPOSE: The aim of this study was to determine the optimal management of patients with colorectal cancer and abdominal aortic aneurysm in the elective situation. METHODS: All patients with a history of colorectal cancer and abdominal aortic aneurysm between 1986 and July 2000 were identified, and charts of those with concomitant disease were reviewed. RESULTS: A total of 435 patients with available charts were reviewed. Eighty-three patients with concomitant abdominal aortic aneurysm and colorectal cancer were identified. In 64 patients the colorectal cancer was treated first, and 44 of these patients had an abdominal aortic aneurysm less than 5 cm in diameter (average = 3.8 cm). No abdominal aortic aneurysm ruptured in the postoperative period. Median delay to colorectal cancer surgery from diagnosis was four days. Twenty patients with abdominal aortic aneurysm of 5 cm or greater (average = 5.4 cm) were treated for colorectal cancer first. In two of these patients (with abdominal aortic aneurysms sized 5 and 6.4 cm), the abdominal aortic aneurysm ruptured in the early postoperative period. Median delay to colorectal cancer resection was eight days. Twelve patients had both abdominal aortic aneurysm and colorectal cancer treated at the same time. The average size of the abdominal aortic aneurysm was 6.4 cm. Median delay from colorectal cancer diagnosis to resection was 15 days. No documented cases of graft infection occurred in this group; median follow-up was 3.2 years. Seven patients underwent abdominal aortic aneurysm repair before resection of colorectal cancer; in two patients, colorectal cancer was found at the time of resection. The average size of abdominal aortic aneurysm was 6 cm and median delay to treatment of colorectal cancer was 122 days, a statistically significant longer delay than in the other two groups (P < 0.0001). CONCLUSION: In patients with colorectal cancer and abdominal aortic aneurysm of 5 cm or more, treatment of colorectal cancer first may result in life-threatening rupture, whereas treatment of abdominal aortic aneurysm first may significantly delay treatment of colorectal cancer. Concomitant treatment seems to be a safe alternative. If anatomically suitable, the abdominal aortic aneurysm may be considered for endovascular repair followed by a staged colon resection. The presence of an abdominal aortic aneurysm less than 5 cm does not affect colorectal cancer treatment.
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References
JD Nora PC Pairolero S Nivatvongs KJ Cherry JW Hallett P Gloviczki (1989) ArticleTitleConcomitant abdominal aortic aneurysm and colorectal carcinoma J Vasc Surg 9 630–635
CC Compton LP Fielding LJ Burgart et al. (2000) ArticleTitlePrognostic factors in colorectal cancer. College of American Pathologists Consensus Statement 1999 Arch Pathol Lab Med 124 979–994
AA Noel P Gloviczki KJ Cherry et al. (1999) ArticleTitleOptimal management of abdominal aortic aneurysm and urologic malignancies Vasc Surg 33 603–609
TO Oshodi JS Abraham JK Brigg JF Kelly (2000) ArticleTitleManagement of co-existing intra-abdominal disease in aortic surgery Eur J Vasc Endovasc Surg 19 43–46
P Bachoo G Cooper J Engeset KS Cross (2000) ArticleTitleManagement of synchronous infrarenal aortic disease and large bowel cancer Eur J Vasc Endovasc Surg 19 614–618
P Gouny J Leschi O Nussaume C Cheynel-Hocquet B Decaix M Vayssairat (1996) ArticleTitleSingle-stage management of abdominal aortic aneurysm and colon cancer Ann Vasc Surg 10 299–305
K Matsumoto M Nakamaru H Obara et al. (1999) ArticleTitleSurgical strategy for abdominal aortic aneurysm with concurrent symptomatic malignancy World J Surg 23 248–251
S Kurata K Nawata S Nawata et al. (1998) ArticleTitleSurgery for abdominal aortic aneurysm associated with malignancy Surg Today 28 895–899
G Robinson W Hughes E Lippey (1994) ArticleTitleAbdominal aortic aneurysm and associated colorectal carcinoma Aust N Z J Surg 64 475–478
JA Herald CJ Young GH White MJ Solomon (1998) ArticleTitleEndosurgical treatment of synchronous rectal cancer and abdominal aortic aneurysm, without laparotomy Surgery 124 932–933
VM Bernhard (1980) ArticleTitleManagement of graft infections following abdominal aortic aneurysm replacement World J Surg 4 679–686
FM Ameli M Weiss JL Provan KW Johnston (1987) ArticleTitleSafety of cholecystectomy with abdominal aortic surgery Can J Surg 30 170–173
DE Szilagyi JP Elliott R Berguer (1967) ArticleTitleCoincidental malignancy and abdominal aortic aneurysm Arch Surg 95 402–412
TA Chuter RM Faruqi R Sawhney et al. (2001) ArticleTitleEndoleak after endovascular repair of abdominal aortic aneurysm J Vasc Surg 34 98–105
CK Zarins RA White D Schwarten et al. (1999) ArticleTitleAneuRx stent graft versus open surgical repair of abdominal aortic aneurysms J Vasc Surg 29 292–308
RL Bush AB Lumsden TF Dodson et al. (2001) ArticleTitleMid-term results after endovascular repair of the abdominal aortic aneurysm J Vasc Surg 33 70–76
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Baxter, N.N., Noel, A.A., Cherry, K. et al. Management of Patients with Colorectal Cancer and Concomitant Abdominal Aortic Aneurysm. Dis Colon Rectum 45, 165–170 (2002). https://doi.org/10.1007/s10350-004-6138-8
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DOI: https://doi.org/10.1007/s10350-004-6138-8