Advertisement

International Journal of Clinical Oncology

, Volume 13, Issue 4, pp 349–354 | Cite as

Long-term outcomes of peripheral arm ports implanted in patients with colorectal cancer

  • Junichiro KawamuraEmail author
  • Satoshi Nagayama
  • Akinari Nomura
  • Atsushi Itami
  • Hiroshi Okabe
  • Seiji Sato
  • Go Watanabe
  • Yoshiharu Sakai
Original Article

Abstract

Background

Venous ports are mandatory for chemotherapy in cancer patients because prolonged infusions are required. The aim of this study was to assess the safety of peripheral arm ports for chemotherapy in patients with colorectal cancer.

Methods

A peripheral venous access port was placed in the upper arm in 113 consecutive patients with metastatic colorectal cancer (MCRC). All patients received modifi ed FOLFOX (5-fl uorouracil [5-FU]/l-leucovorin [LV]/oxaliplatin [L-OHP]) 6 or FOLFIRI (5-FU/LV/irinotecan hydrochloride [CPT-11]) regimens at least once via the venous access port. All patients were followed up at least once every 2 weeks.

Results

Puncture of the basilic veins was successfully completed under real-time sonographic guidance or radiographic guidance in all patients. The median operative time was 30 min. The cumulative follow-up period was 29 886 catheter days (range, 9–560 days; mean, 264 days). No procedural complications, such as pneumothorax, hemothorax, arterial puncture, or cardiovascular problems, occurred in our series. A total of nine patients (8.0%) had complications. Port-site infection occurred in six patients (5.3%; 0.20 infections per 1000 catheter-days). One patient (0.9%) had an episode of ultrasound-documented deep vein thrombosis in the ipsilateral upper extremity (0.03/1000 catheter-days). Dislocation or migration of the catheter tip occurred in two patients (0.07/1000 catheter-days). A second port was placed in six patients (5.3%) after removal of the fi rst port.

Conclusion

Peripheral arm ports can be maintained with excellent short-and long-term outcomes. Peripheral arm ports are considered to be a good alternative to central venous ports implanted in the chest in patients with MCRC.

Key words

Peripheral arm port Colorectal cancer Venous port Chemotherapy 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Kelly H, Goldberg RM (2005) Systemic therapy for metastatic colorectal cancer: current options, current evidence. J Clin Oncol 23:4553–4560PubMedCrossRefGoogle Scholar
  2. 2.
    Di Carlo I, Cordio S, La Greca G, et al. (2001) Totally implantable venous access devices implanted surgically: a retrospective study on early and late complications. Arch Surg 136:1050–1053PubMedCrossRefGoogle Scholar
  3. 3.
    Hinke DH, Zandt-Stastny DA, Goodman LR, et al. (1990) Pinch-off syndrome: a complication of implantable subclavian venous access devices. Radiology 177:353–356PubMedGoogle Scholar
  4. 4.
    Klotz HP, Schöpke W, Kohler A, et al. (1996) Catheter fracture: a rare complication of totally implantable subclavian venous access devices. J Surg Oncol 62:222–225PubMedCrossRefGoogle Scholar
  5. 5.
    Mirza B, Vanek VW, Kupensky DT (2004) Pinch-off syndrome: case report and collective review of the literature. Am Surg 70: 635–644PubMedGoogle Scholar
  6. 6.
    Sofocleous CT, Schur I, Cooper SG, et al. (1998) Sonographically guided placement of peripherally inserted central venous catheters: review of 355 procedures. AJR Am J Roentgenol 170: 1613–1616PubMedGoogle Scholar
  7. 7.
    Neuman ML, Murphy BD, Rosen MP (1998) Bedside placement of peripherally inserted central catheters: a cost-effectiveness analysis. Radiology 206:423–428PubMedGoogle Scholar
  8. 8.
    Lorch H, Zwaan M, Kagel C, et al. (2001) Central venous access ports placed by interventional radiologists: experience with 125 consecutive patients. Cardiovasc Intervent Radiol 24:180–184PubMedCrossRefGoogle Scholar
  9. 9.
    Damascelli B, Patelli G, Frigerio LF, et al. (1997) Placement of long-term central venous catheters in outpatients: study of 134 patients over 24 596 catheter days. AJR Am J Roentgenol 168: 1235–1239PubMedGoogle Scholar
  10. 10.
    Kluge A, Rauber K, Rau WS (1997) Radiologically implanted subcutaneous tunneled central venous catheters for dialysis: the course and complications. Rofo 166:230–232PubMedGoogle Scholar
  11. 11.
    Morris SL, Jaques PF, Mauro MA (1992) Radiology-assisted placement of implantable subcutaneous infusion ports for long-term venous access. Radiology 184:149–151PubMedGoogle Scholar
  12. 12.
    Conreux F, Beydon L, Safran D, et al. (2000) Equipment surveillance of implantable catheter ports (1996–1998). Members of Sub-Commissions 4a and 4b for Equipment Surveillance. Ann Fr Anesth Reanim 19:171–176PubMedGoogle Scholar
  13. 13.
    Marcy PY, Magné N, Castadot P, et al. (2007) Is radiologic placement of an arm port mandatory in oncology patients? Analysis of a large bi-institutional experience. Cancer 110: 2331–2338PubMedCrossRefGoogle Scholar
  14. 14.
    Shetty PC, Mody MK, Kastan DJ, et al. (1997) Outcome of 350 implanted chest ports placed by interventional radiologists. J Vasc Interv Radiol 8:991–995PubMedCrossRefGoogle Scholar
  15. 15.
    Funaki B, Szymski GX, Hackworth CA, et al. (1997) Radiologic placement of subcutaneous infusion chest ports for long-time central venous access. AJR Am J Roentgenol 169:1431–1434PubMedGoogle Scholar
  16. 16.
    Koch HJ, Pietsch M, Krause U, et al. (1998) Implantable vascular access systems: experience in 1500 patients with totally implanted central venous port systems. World J Surg 22:12–16CrossRefGoogle Scholar
  17. 17.
    Biffi R, Martinelli G, Pozzi S, et al. (1999) Totally implantable central venous access ports for high-dose chemotherapy administration and autologous stem cell transplantation: analysis of overall and septic complications in 68 cases using a single type of device. Bone Marrow Transplant 24:89–93PubMedCrossRefGoogle Scholar
  18. 18.
    Deppe G, Kahn ML, Malviya VK, et al. (1996) Experience with the P.A.S.-PORT venous access device in patients with gynecologic malignancies. Gynecol Oncol 62:340–343PubMedCrossRefGoogle Scholar
  19. 19.
    Hata Y, Morita S, Morita Y, et al. (1998) Peripheral insertion of a central venous access device under fl uoroscopic guidance using a peripherally accessed system (PAS) port in the forearm. Cardiovasc Intervent Radiol 21:230–233PubMedCrossRefGoogle Scholar
  20. 20.
    Bodner LJ, Nosher JL, Patel KM, et al. (2000) Peripheral venous access ports: outcomes analysis in 109 patients. Cardiovasc Intervent Radiol 23:187–193PubMedCrossRefGoogle Scholar
  21. 21.
    Burbridge B, Krieger E, Stoneham G (2000) Arm placement of the Cook titanium Petite Vital-Port: results of radiologic placement in 125 patients with cancer. Can Assoc Radiol J 51:163–169PubMedGoogle Scholar
  22. 22.
    Tsuboi N, Morita S, Yamanishi T, et al. (2003) Long-Term outcomes of a totally implantable central venous access system in the forearm (in Japanese). Jpn J Intervent Radiol 18:43–48Google Scholar
  23. 23.
    Kaufman JA, Salamipour H, Geller SC, et al. (1996) Long-term outcomes of radiologically placed arm ports. Radiology 201: 725–730PubMedGoogle Scholar
  24. 24.
    Cunningham MJ, Collins MB, Kredentser DC, et al. (1996) Peripheral infusion ports for central venous access in patients with gynecologic malignancies. Gynecol Oncol 60:397–399PubMedCrossRefGoogle Scholar
  25. 25.
    Kuriakose P, Colon-Otero G, Paz-Fumagalli R. (2002) Risk of deep venous thrombosis associated with chest versus arm central venous subcutaneous port catheters: a 5-year single-institution retrospective study. J Vasc Interv Radiol 13:179–184PubMedCrossRefGoogle Scholar
  26. 26.
    Vescia S, Baumgärtner AK, Jacobs VR, et al. (2008) Management of venous port systems in oncology: a review of current evidence. Ann Oncol 19:9–15PubMedCrossRefGoogle Scholar

Copyright information

© Japan Society of Clinical Oncology 2008

Authors and Affiliations

  • Junichiro Kawamura
    • 1
    Email author
  • Satoshi Nagayama
    • 1
  • Akinari Nomura
    • 1
  • Atsushi Itami
    • 1
  • Hiroshi Okabe
    • 1
  • Seiji Sato
    • 1
  • Go Watanabe
    • 1
  • Yoshiharu Sakai
    • 1
  1. 1.Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan

Personalised recommendations