Leopardi Marco, Di Marco Evelina, Musilli Aldo, Ricevuto Enrico, Bruera Gemma, Ventura Marco
Vascular Surgery Unit, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.
Vascular Surgery Unit, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.
Ann Vasc Surg. 2017 Nov;45:268.e13-268.e20. doi: 10.1016/j.avsg.2017.07.013. Epub 2017 Jul 21.
The aim of the study is to present the results in a consecutive series of patients affected by aortic abdominal aneurysm and to underline the aneurysmal growth and evolution in oncological patients submitted to dedicated oncological medical therapy.
Between January 2010 and June 2016 we treated in our center 19 patients for coexisting aortic aneurysms (>3 cm) and malignancy. We observed patients undergoing oncological treatment and patients who did not undergo medical treatment. We studied computed tomography (CT) scan at the time when patients were addressed at our follow-up or treatment and we analyzed retrospectively prior CT scan at 6 and 12 months.
Among those 19 patients, 7 patients were affected by colorectal cancer (36.8%), 6 by urinary tract cancer (31.6%), 4 by lymphoma (21%), and 2 by lung cancer (10.6%). In 8 patients who did not undergo oncological therapy, we did not observe any aortic growth; instead, in other 4 patients who underwent oncological medical therapy (3 abdominal aortic aneurysms and 1 thoracic aneurysm), we observed a mean sac growth of 2.9 cm in 6 months with 2 cases of aortic rupture treated in urgent fashion. The treatment was open surgery in 2 cases and endovascular in other cases.
We observed that oncological drugs may play a role in aneurysm growth. Few case reports are found in the literature and more evidences are to be found. Those information may influence intention-to-treat small aneurysms in short life expectancy patients.
本研究的目的是呈现一系列连续性腹主动脉瘤患者的结果,并强调接受专门肿瘤内科治疗的肿瘤患者中动脉瘤的生长和演变情况。
2010年1月至2016年6月期间,我们中心治疗了19例同时患有主动脉瘤(直径>3 cm)和恶性肿瘤的患者。我们观察了接受肿瘤治疗的患者和未接受药物治疗的患者。在患者接受随访或治疗时进行计算机断层扫描(CT),并回顾性分析6个月和12个月前的CT扫描结果。
在这19例患者中,7例患有结直肠癌(36.8%),6例患有泌尿系统癌症(31.6%),4例患有淋巴瘤(21%),2例患有肺癌(10.6%)。在8例未接受肿瘤治疗的患者中,未观察到主动脉生长;相反,在其他4例接受肿瘤内科治疗的患者(3例腹主动脉瘤和1例胸主动脉瘤)中,6个月内平均瘤体生长2.9 cm,2例主动脉破裂患者接受了紧急治疗。2例采用开放手术治疗,其他采用血管腔内治疗。
我们观察到肿瘤药物可能在动脉瘤生长中起作用。文献中仅有少数病例报告,需要更多证据。这些信息可能会影响对预期寿命较短患者小动脉瘤的治疗意向。