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  • Muy Kheng MT Asseryanis E

    2019-11-11

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    [15] Michala L, Tsigginou A, Zacharakis D, et al. Breast disorders in girls and adoles-cents. Is there Relebactam need for a specialized service? J Pediatr Adolesc Gynecol 2015;28:91–4.
    [16] Kaneda HJ, Mack J, Kasales CJ, et al. Pediatric and adolescent breast masses: a review of pathophysiology, imaging, diagnosis and treatment. Am J Roentgenol 2013;200: W204–12.
    [24] Ezer SS, Oguzkurt P, Ince E, et al. Surgical treatment of the solid breast masses in fe-male adolescents. J Pediatr Adolesc Gynecol 2013;26:31–5. [25] Kennedy RD, Boughey JC. Management of pediatric and adolescent breast masses. Semin Plast Surg 2013;27:19–22. [26] Daly B, Olopade OI. A perfect storm: how tumor biology, genomics, and health care delivery patterns collide to create a racial survival disparity in breast cancer and pro-posed interventions for change. CA Cancer J Clin 2015;65:221–38. 
    [27] Bownes LV, Stafman LL, Maizlin II, et al. Socioeconomic disparities affect survival in malignant ovarian germ cell tumors in AYA population. J Surg Res 2018;222: 180–6.
    [28] Woods LM, Rachet B, Coleman MP. Origins of socio-economic inequalities in cancer survival: a review. Ann Oncol 2006;17:5–19. [29] Sonmez K, Turkyilmaz Z, Karabulut R, et al. Surgical breast lesions in adolescent pa-tients and a review of the literature. Acta Chir Belg 2006;106:400–4. A population-based cohort study examining the risk of abdominal cancer after endovascular abdominal aortic aneurysm repair
    Sheraz R. Markar, PhD, MA, MSc, MRCS,a Alberto Vidal-Diez, PhD,b,c Viknesh Sounderajah, MRCS,a Hugh Mackenzie, PhD, MRCS,a George B. Hanna, PhD, FRCS,a Matt Thompson, PhD, FRCS,b Peter Holt, PhD, FRCS,b Jesper Lagergren, PhD, MD,d,e and Alan Karthikesalingam, PhD, MA, MSc, MRCS,a,b,c
    London, United Kingdom; and Stockholm, Sweden
    ABSTRACT
    Objective: Endovascular aneurysm repair (EVAR) has increasingly been used as the primary treatment approach for abdominal aortic aneurysm (AAA). This study examined the hypothesis that EVAR leads to an increased risk of abdominal cancer within the radiation field compared with open AAA repair.
    Methods: The nationwide English Hospital Episode Statistics database was used to identify all patients older than 50 years who received an AAA repair in 2005 to 2013. EVAR and open AAA repair groups were compared for the incidence of post-operative cancer using inverse probability weights and G-computation formula to adjust for selection bias and confounding.
    Conclusions: This study suggests an increased risk of abdominal cancer after EVAR compared with open AAA repair. The differential cancer risk should be further explored in alternative national populations, and radiation exposure during EVAR should be measured as a quality metric in the assessment of EVAR centers. (J Vasc Surg 2019;69:1776-85.)
    Keywords: Aneurysm; Endovascular; Open; EVAR; Cancer; Population
    Endovascular aneurysm repair (EVAR) has supplanted open surgery as the most frequently employed treatment of large abdominal aortic aneurysms (AAAs).1,2 In random-ized controlled trials, EVAR has been shown to reduce short-term postoperative mortality, morbidity, and length of hospital stay compared with an open surgical approach, with equivalent longer term mortality.3-5 However, con-cerns have been raised about the “catch-up” in late