Complication-related removal of totally implantable venous access port systems: Does the interval between placement and first use and the neutropenia-inducing potential of chemotherapy regimens influence their incidence? A four-year prospective study of 4045 patients. - 2017
Complication-related removal of totally implantable venous access port systems: Does the interval between placement and first use and the neutropenia-inducing potential of chemotherapy regimens influence their incidence? A four-year prospective study of 4045 patients.
Kakkos, Athanasios; Bresson, L; Hudry, Det al.
2017 • In European Journal of Surgical Oncology, 43 (4), p. 689 - 695
[en] BACKGROUND: 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.
RESULTS: 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).
CONCLUSION: 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.
Disciplines :
Oncology
Author, co-author :
Kakkos, Athanasios ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique ; Department of Oncologic Surgery, Centre Régional de Lutte Contre le Cancer Oscar Lambret, 3 Rue Fréderic Combemale, BP 307, 59020 Lille Cedex, France. Electronic address: athanasios.kakkos@gmail.com
Bresson, L; Department of Oncologic Surgery, Centre Régional de Lutte Contre le Cancer Oscar Lambret, 3 Rue Fréderic Combemale, BP 307, 59020 Lille Cedex, France
Hudry, D; Department of Oncologic Surgery, Centre Régional de Lutte Contre le Cancer Oscar Lambret, 3 Rue Fréderic Combemale, BP 307, 59020 Lille Cedex, France
Cousin, S; Department of Medical Oncology, Centre Régional de Lutte Contre le Cancer Institut Bergonié, 229 Cours de l' Argonne, 33076 Bordeaux Cedex, France
Lervat, C; Department of Pediatric Oncology, Centre Régional de Lutte Contre le Cancer Oscar Lambret, 3 Rue Fréderic Combemale, BP 307, 59020 Lille Cedex, France
Bogart, E; Department of Methodology and Biostatistics, Centre Régional de Lutte Contre le Cancer Oscar Lambret, 3 Rue Fréderic Combemale, BP 307, 59020 Lille Cedex, France
Meurant, J P; Department of Methodology and Biostatistics, Centre Régional de Lutte Contre le Cancer Oscar Lambret, 3 Rue Fréderic Combemale, BP 307, 59020 Lille Cedex, France
El Bedoui, S; Department of Oncologic Surgery, Centre Régional de Lutte Contre le Cancer Oscar Lambret, 3 Rue Fréderic Combemale, BP 307, 59020 Lille Cedex, France
Decanter, G; Department of Oncologic Surgery, Centre Régional de Lutte Contre le Cancer Oscar Lambret, 3 Rue Fréderic Combemale, BP 307, 59020 Lille Cedex, France
Hannebicque, K; Department of Oncologic Surgery, Centre Régional de Lutte Contre le Cancer Oscar Lambret, 3 Rue Fréderic Combemale, BP 307, 59020 Lille Cedex, France
Regis, C; Department of Oncologic Surgery, Centre Régional de Lutte Contre le Cancer Oscar Lambret, 3 Rue Fréderic Combemale, BP 307, 59020 Lille Cedex, France
Hamdani, A; Department of Anesthesiology and Reanimation, Centre Régional de Lutte Contre le Cancer Oscar Lambret, 3 Rue Fréderic Combemale, BP 307, 59020 Lille Cedex, France
Penel, N; Department of Medical Oncology, Centre Régional de Lutte Contre le Cancer Oscar Lambret, 3 Rue Fréderic Combemale, BP 307, 59020 Lille Cedex, France
Tresch-Bruneel, E; Department of Methodology and Biostatistics, Centre Régional de Lutte Contre le Cancer Oscar Lambret, 3 Rue Fréderic Combemale, BP 307, 59020 Lille Cedex, France
Narducci, F; Department of Oncologic Surgery, Centre Régional de Lutte Contre le Cancer Oscar Lambret, 3 Rue Fréderic Combemale, BP 307, 59020 Lille Cedex, France
Complication-related removal of totally implantable venous access port systems: Does the interval between placement and first use and the neutropenia-inducing potential of chemotherapy regimens influence their incidence? A four-year prospective study of 4045 patients.
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