Influence of Malignant Neoplasms on Limb Prognosis in Patients with Peripheral Arterial Disease: A Real World Analysis Based on a Nationwide Database.
It is unclear how malignant neoplasms affect limb prognosis in patients with peripheral arterial disease (PAD). The purpose of this study was to clarify the association between malignant neoplasms and limb outcomes in patients with PAD complicated by chronic limb threatening ischaemia (CLTI).
Data for patients who underwent revascularisation between 2013 - 2015 were collected from the JAPAN Chronic Limb Threatening Ischaemia Database (JCLIMB), established as a part of the National Clinical Database. All patients included in this study had PAD with CLTI and were followed for two years. The prevalence of malignant neoplasms at the time of revascularisation was examined. Overall survival, cardiovascular death, primary patency, and major adverse limb events (MALE) were also investigated.
A total of 2 891 patients were included in the study. The patients underwent surgical revascularisation including hybrid treatment in 1 709 cases, and endovascular treatment in 1 182 cases. Overall, 62 patients (2.1%) had malignant neoplasms at revascularisation (malignancy bearing group). Primary patency and MALE free rates did not differ between patients with and without malignant neoplasms, regardless of treatment type. Overall survival was significantly poorer in the malignancy bearing than in malignancy free groups. Cardiovascular mortality was not significantly different between the malignancy bearing and malignancy free groups, regardless of treatment modality.
Approximately 2% of patients with PAD complicated by CLTI had a malignant neoplasm at the time of revascularisation. The presence of malignant neoplasms did not impact post-operative limb prognosis in patients with CLTI. Therefore, even if diagnosed with malignant neoplasms, there is no need to avoid performing optimal revascularisation for CLTI, including surgical revascularisation, provided the patient's condition and life prognosis are acceptable.
Data for patients who underwent revascularisation between 2013 - 2015 were collected from the JAPAN Chronic Limb Threatening Ischaemia Database (JCLIMB), established as a part of the National Clinical Database. All patients included in this study had PAD with CLTI and were followed for two years. The prevalence of malignant neoplasms at the time of revascularisation was examined. Overall survival, cardiovascular death, primary patency, and major adverse limb events (MALE) were also investigated.
A total of 2 891 patients were included in the study. The patients underwent surgical revascularisation including hybrid treatment in 1 709 cases, and endovascular treatment in 1 182 cases. Overall, 62 patients (2.1%) had malignant neoplasms at revascularisation (malignancy bearing group). Primary patency and MALE free rates did not differ between patients with and without malignant neoplasms, regardless of treatment type. Overall survival was significantly poorer in the malignancy bearing than in malignancy free groups. Cardiovascular mortality was not significantly different between the malignancy bearing and malignancy free groups, regardless of treatment modality.
Approximately 2% of patients with PAD complicated by CLTI had a malignant neoplasm at the time of revascularisation. The presence of malignant neoplasms did not impact post-operative limb prognosis in patients with CLTI. Therefore, even if diagnosed with malignant neoplasms, there is no need to avoid performing optimal revascularisation for CLTI, including surgical revascularisation, provided the patient's condition and life prognosis are acceptable.