Totally implantable venous access port systems are widely used in oncology, with frequent complications that sometimes necessitate device removal. The aim of this study is to investigate the impact of the time interval between port placement and initiation of chemotherapy and the neutropenia-inducing potential of the chemotherapy administered upon complication-related port removal.
Patients and methods
Between January 2010 and December 2013, 4045 consecutive patients were included in this observational, single-center prospective study. The chemotherapy regimens were classified as having a low (<10%), intermediate (10–20%), or high (>20%) risk for inducing neutropenia.
The overall removal rate due to complications was 7.2%. Among them, port-related infection (2.5%) and port expulsion (1%) were the most frequent. The interval between port insertion and its first use was shown to be a predictive factor for complication-related removal rates. A cut-off of 6 days was statistically significant (p = 0.008), as the removal rate for complications was 9.4% when this interval was 0–5 days and 5.7% when it was ≥6 days. Another factor associated with port complication rate was the neutropenia-inducing potential of the chemotherapy regimens used, with removal for complications involved in 5.5% of low-risk regimens versus 9.4% for the intermediate- and high-risk regimens (p = 0.003).
An interval of 6 days between placement and first use of the port reduces the removal rate from complications. The intermediate- and high-risk for neutropenia chemotherapy regimens are related to higher port removal rates from complications than low-risk regimens.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to European Journal of Surgical Oncology
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Complete catheter disconnection and migration of an implantable venous access device: the disconnected cap sign.Ann Vasc Surg. 2010; 24: e11-e15
- The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies.Mayo Clin Proc. 2006; 81: 1159-1171
- Complications and management of long-term central venous access catheters and ports.J Vasc Access. 2004; 5: 174-178
- Totally implantable venous access devices: evaluation of complications and a prospective comparative study of two different port systems.Neth J Med. 2000; 57: 215-223
- Central venous access in oncology: ESMO clinical practice guidelines.Ann Oncol. 2015; 26: v152-v168
- It appears to be safe to start chemotherapy on the day of implantation through subcutaneous venous port catheters in inpatient setting.Support Care Cancer. 2009; 17: 399-403
- Is there any effect of first-day usage of a totally implantable venous access device on complications?.Int J Clin Oncol. 2015; 20: 1057-1062
- Totally implantable venous access port systems and risk factors for complications: a one-year prospective study in a cancer centre.Eur J Surg Oncol. 2011; 37: 913-918
- epic2: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England.J Hosp Infect. 2007; 65: S1-S64
- Catheter replacement of the needle in percutaneous arteriography; a new technique.Acta Radiol. 1953; 39: 368-376
- Update on totally implantable venous access devices.Surg Oncol. 2012; 21: 207-215
- An 11-year retrospective study of totally implanted central venous access ports: complications and patient satisfaction.Eur J Surg Oncol. 2009; 35: 241-246
- Infections related to totally implantable venous-access ports: long-term experience in one center.Cell Biochem Biophys. 2015; 72: 235-240
- A retrospective clinical study: complications of totally implanted central venous access ports.Korean J Thorac Cardiovasc Surg. 2014; 47: 26-31
- Does the implantation technique for totally implantable venous access ports (TIVAPs) influence long-term outcome?.World J Surg. 2016; 40: 284-290
- Totally implantable central venous access ports for long-term chemotherapy. A prospective study analyzing complications and costs of 333 devices with a minimum follow-up of 180 days.Ann Oncol. 1998; 9: 767-773
- A comparative study between two central veins for the introduction of totally implantable venous access devices in 1201 cancer patients.Eur J Surg Oncol. 2008; 34: 222-226
Published online: November 04, 2016
Accepted: October 21, 2016
© 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.