Simultaneous Surgical Treatment of Abdominal Aortic Aneurysm (AAA) and Invasive Transitional Cell Carcinoma

Abstract

A prospective case-control study on simultaneously occurring abdominal aortic aneurysm (AAA) and invasive transitional cell carcinoma of the bladder (TCCB) was carried out to evaluate short- and long-term mortality and morbidity of the one-stage surgical treatment. Methods From January 1995 to December 2000 16 patients presented a concomitant AAA and TCCB. A standard operative protocol included AAA graft replacement before bladder resection and urinary reconstruction. Control patients (16 AAA and 16 TCCB alone) matched according to time of intervention, type of vascular and urinary procedure and pathologic staging. Results No vascular complications and graft infections were observed. Systemic and urologic complications were similar in study and control groups. One patient simultaneously treated for AAA and TCCB died of MI 32 days after surgery after an uncomplicated postoperative period. Estimated 6–year survival rate was 68% in AAA and TCCB patients simultaneously treated, 93% and 54% in matched control patients undergoing AAA and TCCB treatment alone respectively. Conclusions The present study shows that the one-stage is a safe approach to simultaneous occurring AAA and TCCB. Long-term survival of treated patients is dependent upon cancer progression. Whenever endovascular treatment is not advisable, the simultaneous surgical treatment of coexisting AAA and TCCB is recommended in highly specialized centers.