Incidence and evolution of aortic aneurysm in patients with bladder cancer.
OBJECTIVE
The incidence of aortic aneurysm is increasing, due to age, hypertension, hyperlipemia and voluptuary abuse like smoking, the last one of the most important cause of bladder cancer. Our study analyzes the incidence of aortic aneurysm in a group of patients who underwent radical cystectomy for bladder cancer and its evolution during follow-up in relationship with surgical procedure and adjuvant therapy.


METHODS
During pre-operative staging of 173 patients, all affected by bladder cancer and then treated with radical cystectomy, we studied aorta and iliac artery diameters, as a part of our ultrasound scan evaluation. All patients underwent post-operative measurement of normal and abnormal aorta and common iliac artery during follow-up.


RESULTS
At the pre-operative staging 19 patients (10.9%) had aneurysms in the aortic-iliac axis (A.A.). During follow-up in 5 patients the A.A. did not develop, whereas in 14 cases it increased within 12 months after surgery and then with an increase <0.5 mm per year, with no relationship with type of surgical procedure, urinary diversion, adjuvant therapy. No cases required a vascular surgical approach during the follow-up. Only 1 patient of basal 154 normal ones developed an aneurysm of the common right iliac artery, treated with endoprosthesis.


CONCLUSIONS
The natural development or risk of aneurysm rupture in patients with bladder cancer depends on its dimensions but also on radical surgery, urinary diversion or adjuvant therapies. In our experience all these factors seem not to influence aneurysms if present nor determine de-novo development.
Urology Department, University of Perugia, Italy. gigimea@libero.it
Luigi
L
Mearini
Alessandro
A
Zucchi
Gerardo
G
Pizzirusso
Carlo
C
Vivacqua
Ettore
E
Mearini
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000453:epidemiology*; D015653:Cystectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D001749:Urinary Bladder Neoplasms / Q000150:complications* / Q000601:surgery