Skip to main content

Advertisement

SpringerLink
Log in

Increased rates of local complication of central venous catheters in the targeted anticancer therapy era: a 2-year retrospective analysis

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Totally implantable central venous accesses (port-a-cath) are often used for chemotherapy administration or prolonged intravenous infusions in cancer patients. Local and systemic complications may occur both during and after placement of port-a-cath despite the well-established techniques for its placement and care. Out of other catheter-related local complications, thrombosis and infections represent the most common. Complications related to central venous catheter may be associated with infusion of both conventional chemotherapy and molecularly targeted therapy. Incidence and nature of complications of central venous catheter have been well established for long-term chemotherapy. However, very sparse data exists on the incidence of complications of molecularly targeted therapies administered through a central venous catheter. Hence, we decided to retrospectively analyze the local complications of a central venous catheter in patients receiving molecularly targeted therapy and conventional chemotherapy, respectively.

Methods

Over a 2-year period, 459 devices were placed in two academic Italian institutions. Patients’ characteristics, catheter-related complications, and their relationship with targeted therapy administration were retrospectively assessed.

Results

Catheter-related complications occurred in 30 out of the 459 analyzed cancer patients (7 %). Local complications occurred in 12 (40 %) and 18 (60 %) patients receiving standard chemotherapy and biological drugs, respectively. Eighteen (72 %) out of 25 patients developing biological complications (BC) were receiving biological drugs. Infusion of a biological drug through a central venous catheter has been shown to increase the risk of central venous catheter complications (p = 0.02). No difference between the incidence of complication between anti-angiogenic and anti-epidermal growth factor receptor (EGFR) agents was observed in our study despite the statistically significant early development of port-a-cath complication in the anti-EGFR group. Treatment with a biological drug and the stage of disease, in univariate analysis, had independent effect on the duration for development of catheter-related complications.

Conclusions

Molecularly targeted therapy may influence the occurrence of BCs, i.e., infection and dehiscence. Onset of BCs occurred earlier in patients receiving biological drugs (more frequently with bevacizumab than with anti-EGFR therapy) than those undergoing traditional chemotherapy. Further studies are needed to ascertain the findings of our study and to elucidate the reason for the higher incidence of catheter-related complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Biffi R, Corrado F, De Braud F et al (1997) Long term, totally implantable central venous access ports connected to Groshong catheter for chemotherapy of solid tumours: experience on 178 cases using a single type of device. Eur J Cancer 33:1190–1194

    Article  CAS  PubMed  Google Scholar 

  2. Biffi R, De Braud F, Orsi F et al (2001) A randomized, prospective trial of central venous ports connected to standard open-ended or Groshong catheters in adult oncology patients. Cancer 92:1204–1212

    Article  CAS  PubMed  Google Scholar 

  3. Lorch H, Zwaan M, Kagel C, Weiss HD (2001) Central venous access ports placed by interventional radiologists: experience with 125 consecutive patients. Cardiovasc Intervent Radiol 24:180–184

    Article  CAS  PubMed  Google Scholar 

  4. Funaki B, Szymski GX, Hackworth CA et al (1997) Radiologic placement of subcutaneous infusion chest ports for long-term central venous access. AJR Am J Roentgenol 169:1431–1434

    Article  CAS  PubMed  Google Scholar 

  5. Poorter RL, Lauw FN, Bemelman WA, Bakker PJ, Taat CW, Veenhof CH (1996) Complications of an implantable venous access device (Port-a-Cath) during intermittent continuous infusion of chemotherapy. Eur J Cancer 32A(13):2262–2266

    Article  CAS  PubMed  Google Scholar 

  6. Hurwitz H, Fehrenbacher L, Novotny W et al (2004) Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 350:2335–2342

    Article  CAS  PubMed  Google Scholar 

  7. Erinjeri JP, Fong AJ, Kemeny NE et al (2011) Timing of administration of bevacizumab chemotherapy affects wound healing after chest wall port placement. Cancer 117:1296–1301

    Article  CAS  PubMed  Google Scholar 

  8. Los M, Roodhart JM, Voest EE (2007) Target practice: lessons from phase III trials with bevacizumab and vatalanib in the treatment of advanced colorectal cancer. Oncologist 12:443–450

    Article  CAS  PubMed  Google Scholar 

  9. Zhang H, Berezov A, Wang Q, Zhang G, Drebin J, Murali R, Greene MI (2007) ErbB receptors: from oncogenes to targeted cancer therapies. J Clin Invest 117:2051–2058

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. Yildizeli B, Laçin T, Batirel HF et al (2004) Complications and management of long-term central venous access catheters and ports. J Vasc Access 5:174–178

    CAS  PubMed  Google Scholar 

  11. 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 136:1050–1053

    Article  PubMed  Google Scholar 

  12. Tsutsumi S, Fukasawa T, Fujii T et al (2012) Central venous port system-related complications in outpatient chemotherapy for colorectal cancer. Hepatogastroenterology 59:1079–1080

    CAS  PubMed  Google Scholar 

  13. Marcy PY, Magné N, Castadot P et al (2007) Is radiologic placement of arm port mandatory in oncology patients? An analysis of a large bi-institutional experience. Cancer 110:2331–2338

    Article  PubMed  Google Scholar 

  14. Hsieh CC, Weng HH, Huang WS et al (2009) Analysis of risk factors for central venous port failure in cancer patients. World J Gastroenterol 15:1709–1714

    Google Scholar 

  15. Vescia S, Baumgärtner AK, Jacobs VR, Kiechle-Bahat M et al (2008) Management of venous port systems in oncology: a review of current evidence. Ann Oncol 19:9–15

    Article  CAS  PubMed  Google Scholar 

  16. Chang YF, Lo AC, Tsai CH et al (2013) Higher complication risk of totally implantable venous access port systems in patients with advanced cancer—a single institution retrospective analysis. Palliat Med 27:185–191

    Article  PubMed  Google Scholar 

  17. Touré A, Vanhems P, Lombard-Bohas C et al (2012) Totally implantable central venous access port infections in patients with digestive cancer: incidence and risk factors. Am J Infect Control 40:935–939

    Article  PubMed  Google Scholar 

  18. Pinto C, Barone CA, Girolomoni G et al (2011) Management of skin toxicity associated with cetuximab treatment in combination with chemotherapy or radiotherapy. Oncologist 16:228–238

    Article  PubMed Central  PubMed  Google Scholar 

  19. Segaert S, van Cutsem E (2005) Clinical signs, pathophysiology and management of skin toxicity during therapy with epidermal growth factor receptor inhibitors. Ann Oncol 16:1425–1433

    Article  CAS  PubMed  Google Scholar 

  20. Dean NR, Sweeny L, Harari PM et al (2011) Wound healing following combined radiation and cetuximab therapy in head and neck cancer patients. J Wound Care 20:166–170

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Saif MW, Mehra R (2006) Incidence and management of bevacizumab-related toxicities in colorectal cancer. Expert Opin Drug Saf 5:553–566

    Article  CAS  PubMed  Google Scholar 

  22. Nissen NN, Polverini PJ, Koch AE et al (1998) Vascular endothelial growth factor mediates angiogenic activity during the proliferative phase of wound healing. Am J Pathol 152:1445–1452

    PubMed Central  CAS  PubMed  Google Scholar 

  23. Scappaticci FA, Fehrenbacher L, Cartwright T et al (2005) Surgical wound healing complications in metastatic colorectal cancer patients treated with bevacizumab. J Surg Oncol 91:173–180

    Article  CAS  PubMed  Google Scholar 

  24. Erinjeri JP, Fong AJ, Kemeny NE et al (2002) Timing of administration of bevacizumab chemotherapy affects wound healing after chest wall port placement. Cancer 94:245–251

    Article  Google Scholar 

  25. Grenader T, Goldberg A, Verstandig A et al (2010) Indwelling central venous access port insertion during bevacizumab-based therapy. Anticancer Drugs 21:704–707

    Article  CAS  PubMed  Google Scholar 

  26. Zawacki WJ, Walker TG, DeVasher E et al (2009) Wound dehiscence or failure to heal following venous access port placement in patients receiving bevacizumab therapy. J Vasc Interv Radiol 20:624–627

    Article  PubMed  Google Scholar 

  27. Beckers MM, Ruven HJ, Seldenrijk CA, Prins MH, Biesma DH (2010) Risk of thrombosis and infections of central venous catheters and totally implanted access ports in patients treated for cancer. Thromb Res 125:318–321

    Article  CAS  PubMed  Google Scholar 

  28. Biffi R, de Braud F, Orsi F, Pozzi S, Mauri S, Goldhirsch A, Nolè F, Andreoni B (1998) 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 9:767–773

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

All the authors have no financial disclosures to declare.

Author information

Authors and Affiliations

  1. Medical Oncology Unit, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I – GM Lancisi – G Salesi, Via Conca 71, 60126, Ancona, Italy

    R. Berardi, S. Rinaldi, R. Giampieri, E. Maccaroni, F. Marcucci, M. Francoletti, A. Onofri, A. Lucarelli, C. Pierantoni & S. Cascinu

  2. Medical Oncology, University Campus Bio-Medico, Via Álvaro del Portillo, 21, 00128, Rome, Italy

    D. Santini, B. Vincenzi & G. Tonini

Authors
  1. R. Berardi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Rinaldi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. Santini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. B. Vincenzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. R. Giampieri
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. E. Maccaroni
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. F. Marcucci
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. M. Francoletti
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. A. Onofri
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. A. Lucarelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. C. Pierantoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. G. Tonini
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. S. Cascinu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R. Berardi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Berardi, R., Rinaldi, S., Santini, D. et al. Increased rates of local complication of central venous catheters in the targeted anticancer therapy era: a 2-year retrospective analysis. Support Care Cancer 23, 1295–1302 (2015). https://doi.org/10.1007/s00520-014-2466-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-014-2466-y

Keywords

Search

Navigation