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The duration of functioning of a subcutaneous implantable port for the treatment of hematological tumors: a single institution-based study

International Journal of Clinical Oncology volume 15, pages 172–178 (2010)Cite this article

Abstract

Background

Although subcutaneous implantable ports have been indicated as venous access for chemotherapy, these devices have not been used routinely for hematological tumors.

Methods

Between May 2006 and April 2009, 39 ports were implanted in 37 patients with hematological tumors and 16 ports were implanted in 14 patients with nonhematological tumors. The patients were treated with standard/first-line and/or salvage/second-line or greater chemotherapy, and were prospectively followed until port removal, death, or the end of the study.

Results

Thirty-five (96%) patients with hematological tumors developed grade 4 hematological toxicity, while 1 (7%) patient with nonhematological tumors showed grade 4 neutropenia. The actual duration of the port in situ ranged from 14 to 719 days (mean, 271.4 days) in the hematology group, and from 50 to 955 days (mean, 419.5 days) in the nonhematology group (P = 0.039). The Kaplan–Meier-estimated median duration of port in situ in the hematology group was 364 days, which was significantly shorter than that in the nonhematology group (P = 0.009). When patient death and port removal for the end of treatment were censored, the rate of port functioning at 1 year was estimated to be 83% in the hematology group. Bloodstream infection (BSI) occurred in 7 patients with hematological tumors and in 1 patient with metastatic colorectal cancer; however, microbiological confirmation that the implantable port was the source of the BSI was inconclusive.

Conclusion

The duration of port functioning in patients with hematological tumors was comparable to that in patients with nonhematological tumors. The higher rate of BSI in the hematology group was primarily attributable to profound neutropenia.

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References

  1. Gallieni M, Pittiruti M, Biffi R (2008) Vascular access in oncology patients. CA Cancer J Clin 58:323–346

    Article  PubMed  Google Scholar 

  2. Groeger JS, Lucas AB, Thaler HT et al (1993) Infectious morbidity associated with long-term use of venous access devices in patients with cancer. Ann Intern Med 119:1168–1174

    CAS  PubMed  Google Scholar 

  3. Schwarz RE, Groeger JS, Coit DG (1997) Subcutaneously implanted central venous access devices in cancer patients: a prospective analysis. Cancer 79:1635–1640

    Article  CAS  PubMed  Google Scholar 

  4. Inaba Y, Yamaura H, Sato Y et al (2007) Central venous access port-related complications in outpatient chemotherapy for colorectal cancer. Jpn J Clin Oncol 37:951–954

    Article  PubMed  Google Scholar 

  5. Kawamura J, Nagayama S, Nomura A et al (2008) Long-term outcomes of peripheral arm ports implanted in patients with colorectal cancer. Int J Clin Oncol 13:349–354

    Article  PubMed  Google Scholar 

  6. O’Neil BH, Goldberg RM (2008) Innovations in chemotherapy for metastatic colorectal cancer: an update of recent clinical trials. Oncologist 13:1074–1083

    Article  PubMed  Google Scholar 

  7. Biffi R, Pozzi S, Agazzi A et al (2004) Use of totally implantable central venous access ports for high-dose chemotherapy and peripheral blood stem cell transplantation: results of a monocentre series of 376 patients. Ann Oncol 15:296–300

    Article  CAS  PubMed  Google Scholar 

  8. Boersma RS, Jie KS, Verbon A et al (2008) Thrombotic and infectious complications of central venous catheters in patients with hematological malignancies. Ann Oncol 19:433–442

    Article  CAS  PubMed  Google Scholar 

  9. Johansson E, Bjorkholm M, Bjorvell H et al (2004) Totally implantable subcutaneous port system versus central venous catheter placed before induction chemotherapy in patients with acute leukaemia—a randomized study. Support Care Cancer 12:99–105

    Article  PubMed  Google Scholar 

  10. Kurul S, Saip P, Aydin T (2002) Totally implantable venous-access ports: local problems and extravasation injury. Lancet Oncol 3:684–692

    Article  PubMed  Google Scholar 

  11. Samaras P, Dold S, Braun J et al (2008) Infectious port complications are more frequent in younger patients with hematologic malignancies than in solid tumor patients. Oncology 74:237–244

    Article  PubMed  Google Scholar 

  12. Maki DG, Kluger DM, Crnich CJ (2006) The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc 81:1159–1171

    Article  PubMed  Google Scholar 

  13. Karthaus M, Doellmann T, Klimasch T et al (2002) Central venous catheter infections in patients with acute leukemia. Chemotherapy 48:154–157

    Article  CAS  PubMed  Google Scholar 

  14. Nosari AM, Nador G, De Gasperi A et al (2008) Prospective monocentric study of non-tunnelled central venous catheter-related complications in hematological patients. Leuk Lymphoma 49:2148–2155

    Article  PubMed  Google Scholar 

  15. Johansson E, Engervall P, Bjorvell H et al (2009) Patients’ perceptions of having a central venous catheter or a totally implantable subcutaneous port system-results from a randomised study in acute leukaemia. Support Care Cancer 17:137–143

    Article  PubMed  Google Scholar 

  16. Raad I, Hanna H, Maki D (2007) Intravascular catheter-related infections: advances in diagnosis, prevention, and management. Lancet Infect Dis 7:645–657

    Article  PubMed  Google Scholar 

  17. Mermel LA, Farr BM, Sherertz RJ et al (2001) Guidelines for the management of intravascular catheter-related infections. Clin Infect Dis 32:1249–1272

    Article  CAS  PubMed  Google Scholar 

  18. Allan DS, Buckstein R, Imrie KR (2001) Outpatient supportive care following chemotherapy for acute myeloblastic leukemia. Leuk Lymphoma 42:339–346

    Article  CAS  PubMed  Google Scholar 

  19. Halim TY, Song KW, Barnett MJ et al (2007) Positive impact of selective outpatient management of high-risk acute myelogenous leukemia on the incidence of septicemia. Ann Oncol 18:1246–1252

    Article  CAS  PubMed  Google Scholar 

  20. Imataki O, Tamai Y, Watanabe M et al (2006) Central venous catheter-related thrombosis with infection in cancer patients—2 cases. Gan To Kagaku Ryoho 33:1353–1356

    PubMed  Google Scholar 

  21. Tobinai K, Hotta T (2004) Clinical trials for malignant lymphoma in Japan. Jpn J Clin Oncol 34:369–378

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors wish to thank Drs. Kazuo Otsuka, Shunsuke Yamagishi, Akihiro Kitaoka, Shingo Iwata, Hirofumi Masumoto, and Hitoshi Kato of the Department of Surgery, Takeda General Hospital, for performing port implantation surgery. Allogeneic hematopoietic stem cell transplantation was conducted at the Department of Hematology and Oncology, Kyoto University Hospital.

Conflict of interest statement

No author has any conflict of interest.

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Affiliations

  1. Department of Hematology, Takeda General Hospital, 28-1 Ishida-Moriminami-cho, Fushimi-ku, Kyoto, 601-1495, Japan

    Hitoshi Ohno, Chisaki Mizumoto, Yoshihiro Otsuki, Shigeru Oguma & Yataro Yoshida

  2. Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Chisaki Mizumoto

Authors
  1. Hitoshi Ohno
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  2. Chisaki Mizumoto
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  3. Yoshihiro Otsuki
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  4. Shigeru Oguma
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  5. Yataro Yoshida
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Correspondence to Hitoshi Ohno.

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Ohno, H., Mizumoto, C., Otsuki, Y. et al. The duration of functioning of a subcutaneous implantable port for the treatment of hematological tumors: a single institution-based study. Int J Clin Oncol 15, 172–178 (2010). https://doi.org/10.1007/s10147-010-0039-8

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  • DOI: https://doi.org/10.1007/s10147-010-0039-8

Keywords

  • Subcutaneous implantable port
  • Hematological tumors
  • Chemotherapy
  • Bloodstream infection
  • Port-related complication