Outcomes of Abdominal Aortic Aneurysm Repair in Patients with Recent Intraabdominal Malignancy Diagnosis

INTRODUCTION: A significant proportion of patients undergoing repair of abdominal aortic aneurysm (AAA) have a prior diagnosis of cancer. It is not uncommon for older patients to be diagnosed with AAA while undergoing evaluation for intra-abdominal malignancy. Outcomes following AAA repair in patients with recent intra-abdominal malignancy diagnosis are not well described. METHODS: For this retrospective cohort study, we used the 2005-2014 SEER Medicare database to examine outcomes of AAA repair in patients with a recent intra-abdominal malignancy diagnosis. Patients who had undergone AAA repair within two years following a cancer diagnosis were included in the study. Kaplan-Meir curves and survival models were assessed, stratified by cancer stage, and compared to outcomes of AAA repair in a cohort of patients without cancer. RESULTS: We identified 2418 patients with cancer and 2680 patients without cancer who had AAA repairs. Cancer stages were: 53% stage I, 31% stage II, 11% stage III and 5% stage IV (Figure). Cancer patients were less likely to undergo open repair (20% vs 28% p < 0.001) or emergent repairs (15% vs 24% p < 0.001). Survival two years after AAA repair was 81% for patients without cancer and 78% for the cancer cohort. Survival by stage was 80% for stage I, 80% for stage II, 67% for stage III and 31% for stage IV cancer patients (p = 0.002). CONCLUSION: Survival is worse for patients who had a recent cancer diagnosis prior to AAA repair. Patients with late-stage malignancies had significantly poorer prognosis. This data could help guide informed decision-making.Figure