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Concomitant abdominal aortic aneurysm and colorectal cancer: A decision analysis approach to a therapeutic dilemma

  • Original Articles
  • Published:
Annals of Vascular Surgery

Abstract

The therapeutic approach to a patient with concomitant abdominal aortic aneurysm and colorectal carcinoma is not clear. Decision analysis helps clarify decision options and quantify therapeutic outcomes. Variables used in decision analysis include life expectancy after resection for colorectal cancer and abdominal aortic aneurysm, rupture rate of abdominal aortic aneurysm, complications of colorectal cancer, complications of abdominal aortic aneurysmorrhaphy, and colorectal resection. The results support the concept that the symptomatic lesion should be treated first. When both lesions are asymptomatic and the aneurysm is 4–5 cm in diameter, it should be resected first, if the colorectal cancer has a <5% chance of obstruction or perforation, as is found in noncircumferential lesions. When the aneurysm is >5 cm, it should be resected first if the cancer has a <22% chance of obstructing or perforating, as with circumferential lesions. Simultaneous resection should be considered for patients with aneurysms >5 cm and cancers with a >75–80% chance of obstruction or perforation, provided the dual procedures can be performed with a <10% operative mortality and <50% complication. rate.

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Authors and Affiliations

  1. General and Vascular Surgery Services, Department of Surgery, Madigan Army Medical Center, 98431, Tacoma, Washington

    Vic Velanovich MD & Charles A. Andersen MD

Authors
  1. Vic Velanovich MD
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  2. Charles A. Andersen MD
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The views expressed in this article are those of the author and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the United States Government.

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Velanovich, V., Andersen, C.A. Concomitant abdominal aortic aneurysm and colorectal cancer: A decision analysis approach to a therapeutic dilemma. Annals of Vascular Surgery 5, 449–455 (1991). https://doi.org/10.1007/BF02133050

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