Management of concurrent colorectal cancer and vascular disease in the endovascular era

Spanos, Constantine P.; Tsoulfas, Georgios; Georgantis, G.; Melas, Nikolaos; Saratzis, Nikolaos; Ktenidis, Kiriakos; Lazaridis, Ioannis; Mekras, A.; Syrakos, Theodoros; Kiskinis, Dimitrios

doi:10.1007/s10151-011-0732-2

Cited by 4 publications

(2 citation statements)

References 10 publications

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“…Whereas, for the fear of precipitating aneurysmal rupture, medical oncologists were very reluctant to perform neoadjuvant chemoradiation with an unrepaired AAA [23, 24]. Therefore, endovascular repair of AAA or AAD first may allow safe performance of neoadjuvant chemoradiation therapy for downstaging of gastrointestinal cancer [2, 23]. After 115 days of endovascular repair, one patient (case 1) with rectal cancer was treated from open surgery with neoadjuvant chemotherapy (FOLFOX regimen, 3 courses).…”

Section: Discussionmentioning

confidence: 99%

“…As the aging population increases, the incidence of gastrointestinal cancer and vascular diseases, such as abdominal aortic aneurysm (AAA) and abdominal aortic dissection (AAD), has increased [1, 2]. Though the true incidence is difficult to accurately ascertain, the synchronous presentation of AAA or AAD and gastrointestinal tumor is still rare (0.49% to 2.1% in most series [3, 4]).…”

Section: Introductionmentioning

confidence: 99%

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Synchronous Gastrointestinal Tumor and Abdominal Aortic Aneurysm or Dissection Treated with Endovascular Aneurysm Repair Followed by Tumor Resection

Zhang

Liu

et al. 2019

Gastroenterology Research and Practice

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Objective To evaluate the strategy in the management of patients with synchronous gastrointestinal tumor and abdominal aortic aneurysm (AAA) or abdominal aortic dissection (AAD) undergoing endovascular repair followed by tumor resection. Materials and Methods Five patients with synchronous gastrointestinal tumor and AAA or AAD were treated by endovascular repair followed by tumor resection. Clinical data were retrospectively analyzed with respect to the management strategy, safety, and outcome. Results Endovascular repair was technically successful in all patients. All the stents were well positioned and well patent, and the AAA (n = 3) or AAD (n = 2) were correctly excluded without endoleaks. After endovascular repair, all patients underwent resection of gastrointestinal tumor. No late mortality or major complications related to the two procedures were observed in the subsequent follow-up. Conclusion Our results demonstrate that EVAR could significantly shorten the delay between AAA and gastrointestinal procedure with an excellent postoperative outcome. If the anatomical criteria are satisfied, EVAR followed by tumor resection might be an effective treatment for concomitant AAA and gastrointestinal tumor.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Synchronous Gastrointestinal Tumor and Abdominal Aortic Aneurysm or Dissection Treated with Endovascular Aneurysm Repair Followed by Tumor Resection

Zhang

Liu

et al. 2019

Gastroenterology Research and Practice

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Meta-analysis of Outcomes Following Aneurysm Repair in Patients with Synchronous Intra-abdominal Malignancy

Kumar

Dattani

Asaad

et al. 2016

European Journal of Vascular and Endovascular Surgery

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What this study adds to the existing literature and how it will influence future clinical practice 22The aim of this study was to determine outcomes in patients undergoing abdominal aortic aneurysm 23 (AAA) repair [endovascular (EVAR) or open] who have a synchronous malignancy. Synchronous intra-24 abdominal cancer is relatively common in patients undergoing AAA-repair and surgeons are faced with 25the dilemmas of what type of repair to offer and in what sequence. Our findings support that EVAR is 26 superior regarding short-term mortality. Both EVAR and OAR were associated with significant short-27 term morbidity, which merits careful planning and close follow-up in this patient group. Future studies 28should look into the optimal timing of AAA-repair, for which limited data exist. analysis was applied to assess mortality and major-morbidity at 30-days and long-term. 51 Results:The literature review identified 36 series (543 patients) and the majority (18 series) reported 52 on patients with colorectal-malignancy and AAA. Mean weighted-mortality for OAR at 30-days was 53 11% [95% Confidence Interval (CI): 6.6% to 17.9%]; none of the EVAR patients died peri-operatively. 54The weighted 30-day major complication-rate for EVAR was 20.4% (10.0% to 37.4%) and for OAR it 55 was 15.4% (7.0% to 30.8%). Most patients had their AAA and malignancy treated non-simultaneously 56 (56.6%, 95% CI: 42.1% to 70.1%). In the EVAR cohort 3 patients (4.6%) died at last follow up (range 57 24 to 64 months). In the OAR cohort 23 (10.6%) had died at last follow up (range from 4 to 73 months). 58 Conclusion:In this meta-analysis, OAR was associated with significant peri-operative mortality in 59 patients with an IAM. EVAR should be the first line modality of AAA repair. The majority of patients 60were not treated simultaneously for the two pathologies, but further investigation is necessary to define 61 the optimal timing for each procedure and malignancy. 62

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Synchronous colorectal cancer and abdominal aortic aneurysm treated simultaneously. Is a one-stage surgery a feasible treatment?

Batanero

Díaz-Maag

Parra-Rina

et al. 2022

Acta Chirurgica Belgica

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Management of concurrent colorectal cancer and vascular disease in the endovascular era

Abstract: Priority of treating concurrent vascular disease and CRC remains a dilemma. Combined treatment with a single-stage procedure is feasible. Risk of graft infection may be lower than expected.

Cited by 4 publications

References 10 publications

Synchronous Gastrointestinal Tumor and Abdominal Aortic Aneurysm or Dissection Treated with Endovascular Aneurysm Repair Followed by Tumor Resection

Synchronous Gastrointestinal Tumor and Abdominal Aortic Aneurysm or Dissection Treated with Endovascular Aneurysm Repair Followed by Tumor Resection

Meta-analysis of Outcomes Following Aneurysm Repair in Patients with Synchronous Intra-abdominal Malignancy

Synchronous colorectal cancer and abdominal aortic aneurysm treated simultaneously. Is a one-stage surgery a feasible treatment?

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