title: Frequency of cancer in patients operated on for acute peripheral arterial thrombosis and the impact on prognosis.
abstract: OBJECTIVE
  Little is known about acute peripheral arterial thrombosis in patients with concomitant cancer. Small studies suggest that revascularization in this patient group is associated with thrombosis and increased risk of amputation and death. We investigated the frequency of cancer in patients operated on for acute peripheral arterial thrombosis and the long-term risk of amputation, mortality, myocardial infarction, and stroke in a national cohort.
  
  
  METHODS
  This was a prospective case/noncase study comprising all Danish citizens undergoing vascular surgery for acute arterial thrombosis from 1986 to 2012 with up to 26 years of follow-up.
  
  
  RESULTS
  A total of 7840 patients were treated surgically for acute arterial thrombosis; 2384 (30.4%) were previously diagnosed with cancer or developed cancer during the observation period. Risk of amputation was not significantly different in patients with or without cancer, except in patients with cancer diagnosed <24 months before acute limb ischemia (hazard ratio, 2.0). Mortality was significantly greater in all patients having or developing cancer within 24 months after surgery (hazard ratio, 1.2-2.2). The frequencies of myocardial infarction and stroke were similar to those among patients without cancer.
  
  
  CONCLUSIONS
  One of five patients operated on for acute limb ischemia has a diagnosis of cancer, and a further 3.4% will develop cancer within 24 months. The data further show that patients with acute limb ischemia and concomitant cancer can be successfully revascularized and that the majority of these patients preserve their limb. Cancer should therefore not contravene interventional treatment.
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Chalotte Winther
authors.initials: CW
authors.lastname: Nicolajsen
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Maja Holch
authors.initials: MH
authors.lastname: Dickenson
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Jacob
authors.initials: J
authors.lastname: Budtz-Lilly
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark; Danish Vascular Registry, Aarhus University Hospital, Aarhus, Denmark. Electronic address: eldrup@clin.au.dk.
authors.forename: Nikolaj
authors.initials: N
authors.lastname: Eldrup
mesh_terms: D000671:Amputation, Surgical / Q000706:statistics & numerical data; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D005770:Gastrointestinal Neoplasms / Q000453:epidemiology; D019337:Hematologic Neoplasms / Q000453:epidemiology; D006801:Humans; D007511:Ischemia / Q000453:epidemiology* / Q000601:surgery; D007866:Leg / Q000098:blood supply*; D009203:Myocardial Infarction / Q000453:epidemiology; D009369:Neoplasms / Q000453:epidemiology* / Q000401:mortality; D058729:Peripheral Arterial Disease / Q000453:epidemiology* / Q000601:surgery; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D020521:Stroke / Q000453:epidemiology; D016019:Survival Analysis; D013927:Thrombosis / Q000453:epidemiology* / Q000601:surgery