Outcomes after aortic aneurysm repair in patients with history of cancer: a nationwide dataset analysis

Ahn, Sungyoon; Min, Jin Young; Kim, Hyunyoung G.; Mo, Hyejin; Min, Sang Il; Ha, Jong‐Won; Min, Kyoung Bok

doi:10.1186/s12893-020-00754-3

Cited by 5 publications

(3 citation statements)

References 25 publications

(27 reference statements)

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“…Another interesting finding of our study was that a medical history of cancer resulted in a 2.5 fold increase in risk for long-term mortality. A long-term outcome study of AAA patients, by Ahn et al documented that mortality was significantly higher in patients with a history of malignancy [16]. The rate of cancer was four times higher in the long-term mortality group compared to the survivors group in the current study.…”

Section: Discussionsupporting

confidence: 49%

Glasgow Aneurysm Score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm?

Özen

Yılmaz²,

Yiğit

et al. 2021

BMC Cardiovasc Disord

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Background To evaluate the value of Glasgow Aneurysm Score (GAS) in predicting long-term mortality and survival in patients who have undergone endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). Methods A retrospective single-center study of 257 patients with non-ruptured AAA undergoing EVAR between January 2013 and 2021. GAS scores were compared between the survivors (group 1) and the long-term mortality (group 2) groups. Cox regression analysis was used to determine independent predictors of late mortality. Receiver operating characteristic curve (ROC) analysis was used to determine the optimum cut-off values of GAS values to determine the effect on late-mortality. Survival analysis was conducted using Kaplan-Meier. Results The study included 257 patients with a mean age of 69.75 ± 7.75 (46–92), who underwent EVAR due to AAA. Average follow up period was 18.98 ± 22.84 months (0–88). Fourty-five (17.8%) mortalities occured during long-term follow-up. A past medical history of cancer resulted in a 2.5 fold increase in risk of long-term mortality (OR: 2.52, 95% CI 1.10–5.76; p = 0.029). GAS values were higher in group 2 compared to group 1 (81.02 ± 10.33 vs. 73.73 ± 10.46; p < 0.001). The area under the ROC curve for GAS was 0.682 and the GAS cut-off value was 77.5 (specificity 64%, p < 0.001). The mortality rates in patients with GAS < 77.5 and GAS > 77.5 were: 12.8% and 24.8% respectively (p = 0.014). Every 10 point increase in GAS resulted in approximately a 2 fold increase in risk of long-term mortality (OR: 1.8, 95% CI 1.3–2.5; p < 0.001). Five year survival rates in patients with GAS < 77.5 and > 77.5 were 75.7% and 61.7%, respectively (p = 0.013). Conclusions The findings of our study suggests that an increase in GAS score may predict long-term mortality. In addition, the mortality rates in patients above the GAS cut-off value almost doubled compared to those below. Furthermore, the presence of a past history of cancer resulted in a 2.5 fold increase in long-term mortality risk. Addition of cancer to the GAS scoring system may be considered in future studies. Further studies are necessary to consolidate these findings.

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Section: Discussionsupporting

confidence: 49%

Glasgow Aneurysm Score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm?

Özen

Yılmaz²,

Yiğit

et al. 2021

BMC Cardiovasc Disord

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“…Another interesting nding of our study was that the presence of malignancy resulted in a 5 fold increase in risk for long-term mortality. A long-term outcome study of AAA patients, by Ahn et al documented that mortality was signi cantly higher in patients with a history of malignancy [17]. The rate of malignancy was four times higher in the long-term mortality group compared to the survivors group in the current study.…”

Section: Discussionsupporting

confidence: 48%

Glasgow Aneursym Score: A Predictor of Long-Term Mortality Following Endovascular Repair of Abdominal Aortic Aneurysm?

Özen

Yılmaz

Yiğit

et al. 2021

Preprint

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Background To evaluate the value of Glasgow Aneurysm Score (GAS) in predicting long-term mortality and survival in patients who have undergone endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). Methods A retrospective single-center study of 257 patients with non-ruptured AAA undergoing EVAR between January 2013 and 2021. GAS scores were compared between the survivors and the long term mortality groups. Receiver operating characteristic curve (ROC) analysis was used to determine the optimum cut-off values of GAS values to determine the effect on late-mortality. Results 257 patients with a mean age of 69.75 ± 7.75 (46–92) underwent EVAR due to AAA. Forty-nine mortalities were observed, 4 (1.5%) were in-hospital mortalities. Fourty-five (17.8%) of the mortalities occured during the long-term follow-up. The average follow up period was 18.98 ± 22.84 months (0–88). GAS values were higher in the long-term mortality group compared to the survivors group (81.02 ± 10.33 vs 73.73 ± 10.46; p < 0.001). The area under the ROC curve for GAS was 0.682 and for a 56% sensitivity rate, the cut-off value for GAS was 77.5 with a specificity of 64% (p < 0.001). The number of patients with GAS values < 77.5 was 155, whilst 98 had GAS values > 77.5. The mortality rates in patients with GAS < 77.5 and GAS > 77.5 were: 12.8% (n = 20) and 24.8% (n = 25), respectively (p = 0.014). Every 1 point increase in GAS score resulted in a 1.06 fold increase in risk of late mortality (OR: 1.06, 95% CI, 1.03–1.09; p < 0.001). Moreover, every 10 point increase in GAS score resulted in almost a 2 fold increase in risk of long-term mortality (OR: 1.8, 95% CI, 1.3–2.5; p < 0.001). The mean survival rate of the patients during the follow up period was 90.6% for the 1st year, 82.6% for the 3rd year and 70.0% for the 5th year. Five year survival rates in patients with GAS < 77.5 and > 77.5 were 75.7% and 61.7%, respectively (p = 0.013). Conclusion Every 10 point increase in GAS score resulted in almost a 2 fold increase in risk of long-term mortality. Moreover, the mortality rates in patients above the GAS cut off value almost doubled compared to those below. Five year survival rates were 14% higher in those with GAS below the cut off value when compared to those above.

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“…It has been reported that an EVAR or OSR in AAA patients with concomitant cancer, has a poor outcome and that AAA patients with a history of cancer undergoing repair have a mortality rate higher than those without any cancer history (21.21% vs. 17.08%, HR = 1.31, 95% CI: 1.17–1.46, p < 0.0001) [ 36 ]. In our cohort of cancer-free AAA patients, surgical treatment (EVAR or OSR) improved survival compared to NOP patients, but not significantly (58% mortality in EVAR + OSR vs. 67% in NOP p = 0.67).…”

Section: Discussionmentioning

confidence: 99%

Association between PET/CT Scan Findings, Treatment, and Cancer Incidence in a Cohort of AAA Patients

Sakalihasan,

Bruls,

Hustinx

et al. 2024

JCM

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Background: Abdominal aortic aneurysm (AAA) is a chronic inflammatory disease that poses several challenges. Given the increasing evidence that AAA patients are more likely to develop cancer and the importance of its early detection, we strived to develop a non-invasive tool based on serial FDG-PET/CT scan examinations to identify, among AAA patients, those at risk of cancer. Methods: Between 2006 and 2011 we recruited 149 AAA patients, free of cancer at baseline, and followed them until the end of 2021. All patients underwent an FDG-PET/CT scan at inclusion and possibly more scans during follow-up. At each medical imaging examination, the aneurysmal FDG uptake was recorded. Patients were stratified based on their aortic wall PET status (negative/positive). Any occurrence of cancer was reported. A Cox regression analysis and competing-risk modeling were applied to the data. Results: The proportion of AAA patients who developed cancer was 31.5% (mean time to diagnosis was 5.7 ± 3.4 years) and the death rate was 59%. A difference in cancer incidence between PET+ and PET− patients was detected (46.8% vs. 27.3%; HR = 1.96, 95%CI: 1.07–3.57, p = 0.028). Moreover, AAA patients undergoing surgical treatment had a lower risk of cancer than unoperated patients (28% vs. 50%; HR = 0.41, 95%CI: 0.21–0.80, p = 0.009). Conclusions: In AAA patients, diagnostic imaging with an FDG-PET/CT scan can help identify those patients at a higher risk of developing cancer. Moreover, the higher cancer risk in non-surgically treated patients calls for further analysis of associations between aneurysm growth and malignant disease.

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Outcomes after aortic aneurysm repair in patients with history of cancer: a nationwide dataset analysis

Cited by 5 publications

References 25 publications

Glasgow Aneurysm Score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm?

Glasgow Aneurysm Score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm?

Glasgow Aneursym Score: A Predictor of Long-Term Mortality Following Endovascular Repair of Abdominal Aortic Aneurysm?

Association between PET/CT Scan Findings, Treatment, and Cancer Incidence in a Cohort of AAA Patients

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