LONG-TERM RESULTS AND PROGNOSTIC FACTORS AFTER REPAIR OF ABDOMINAL AORTIC-ANEURYSM WITH CONCOMITANT MALIGNANCY

Objective. Long-term results after repair df abdominal aortic aneurysm (AAA) with concomitant malignancy were reviewed, and factors which ma y affect survival were analyzed. Design Retrospective series with foll ow-up of three to 125 months. Setting. Department of Surgery, Matsuyam a Red Cross Hospital Matsuyama, Japan.Patients. Among 112 consecutive repairs of AAA 16 cases had concomitant malignancy. The malignant lesi ons included eight gastric cancers and eight other malignat tumours. T he malignancies were divided using the TNM Classification into an earl y stage (stage O or I) group (n = 9) and an advanced stage (stage II, III, or IV) group (n = 7). Interventions. All aneurysms were successfu lly repaired, and simultaneous resection of the concomitant malignancy was performed in five cases. While 13 malignant lesions were resected completely, three could not be resected completely, but were treated by other surgical procedures. Measures. Survival rates were predicted using the Kaplan-Meier method. The log-rank test was used to compare s urvival rates. Results. The one-, two-, and five-year survival rates a fter repair of AAA were 80%, 72% and 63%, respectively. The survival r ates for the early stage group were significantly higher than those fo r the advanced stage group (p < 0.05). Patients with concomitant gastr ic cancer or who underwent complete resection of the malignant lesion survived longer. Conclusion. In patients with concomitant AAA and mali gnancy, factors influencing survival for those with malignant lesions also affected survival after aneurysmectomy. Detection of early-stage concomitant malignancy and more aggressive treatment for the malignanc y may improve the outcome.