Chemotherapy is associated with faster abdominal aortic aneurysm growth in patients with concomitant cancer in a multicenter cohort.

OBJECTIVE: To investigate the prevalence of synchronous Abdominal Aortic Aneurysm (AAA) and malignancy and the impact of different cancer treatments on the natural history of aortic aneurysms, focusing on its growth and risk of rupture. DESIGN: Retrospective multicenter observational study. METHODS: Imaging scans were examined to select patients with abdominal aortic aneurysms. Aortic diameters, aortic rupture, demographic and clinical data from patients with abdominal aortic aneurysms with or without cancer (controls) treated at four medical centers in Brazil were retrospectively analyzed. RESULTS: 27,455 abdominal scans were screened, resulting in 297 patients with AAA being included. Of these patients, 220 had concomitant cancer. The prevalence of AAA and cancer was 2.4%. A further 73 patients with AAA but no cancer were recruited from an outpatient cohort to also join the control group of 77 patients, resulting in 150. No aortic rupture was observed. In multivariable analysis, larger baseline aortic diameter (p < 0.001) and exposure to alkylating agents (p = 0.023), antimetabolites (p = 0.023), and topoisomerase inhibitors (p = 0.003) were independently associated with increased AAA growth rates. Neither cancer diagnosis nor radiotherapy exposure was significantly associated with AAA growth. CONCLUSIONS: 2.4% of cancer patients had a concomitant AAA. Aneurysm growth rates were significantly influenced by the initial aortic diameter and by treatment with three classes of chemotherapy drugs: alkylating agents, antimetabolites and topoisomerase inhibitors.