Skip to main content

Advertisement

SpringerLink
Log in

Radiological and surgical placement of port devices: a 4-year institutional analysis of procedure performance, quality of life and cost in breast cancer patients

  • Report
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Summary

Purpose. The present study is designed to evaluate and compare percutaneous radiologic arm port (R) and surgical subclavian port (S) devices in two homogeneous sets of breast cancer patients in terms of safety, efficacy, quality of life (QoL) and cost analysis.

Material and methods. This study involved a retrospective review of a prospective databank including 200 consecutive port device implantation attempted procedures performed over a 4-year period, in two similar groups of 100 breast cancer women who underwent either the surgical cephalic vein cutdown approach or the percutaneous basilic vein catheterization for intravenous adjuvant chemotherapy. Parameters analyzed included technical success, procedure duration, complications, QoL and cost evaluation for both techniques.

Results. The success rate for port implantation was higher for R than for S placement (96% versus 91%). Mean implant duration time was 5.6 and 7.6 months for R and S, respectively. The overall complication rate was 10 and 16% for R and S, respectively. Mean implant duration time, without any complication or death, was 6.4 and 7.8 months for R and S, respectively. Six and seven percent for R and S, respectively, had to be removed prematurely. Both techniques exhibited very good QoL. Direct costs were respectively 230.8 and 219.1 € for R and S, respectively.

Conclusion. The significant advantages of R over S include higher success rate, higher cosmetic results despite a 15% relative overcost for R placement. Both are indicated for breast cancer chemotherapy treatment, nevertheless R placement is mandatory in anxious patients who fear surgery, in case of previous cervico-thoracic irradiation or upper extremity venous thrombosis, or in patients at risk of respiratory insufficiency.

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

Similar content being viewed by others

References

  1. JE Niederhuber W Ensminger JW Gyves M Liepman K Doan E Cozzi (1982) ArticleTitleTotally implanted venous and arterial access system to replace external catheters on cancer treatment Surgery 92 706–712 Occurrence Handle1:STN:280:BiyD3MjhtF0%3D Occurrence Handle7123491

    CAS  PubMed  Google Scholar 

  2. AM Pullyblank PD Carey SZ Pearce AG Tanner PJ Guillou JR Monson (1994) ArticleTitleComparison between peripherally implanted ports and externally sited catheters for long-term venous access Ann R Coll Surg Engl 76 33–38 Occurrence Handle1:STN:280:ByuC287ktlI%3D Occurrence Handle8117017

    CAS  PubMed  Google Scholar 

  3. HJ Kock M Pietsch U Krause H Wilke FW Eigler (1998) ArticleTitleImplantable vascular access systems: experience in 1500 patients with totally implanted central venous port systems World J Surg 22 12–16 Occurrence Handle1:STN:280:DyaK1c7is12jsQ%3D%3D Occurrence Handle9465755

    CAS  PubMed  Google Scholar 

  4. I Di Carlo S Cordio G La Greca G Privitera D Russello S Pulco F Latteri (2001) ArticleTitleTotally implantable venous access devices implanted surgically. A retrospective study on early and late complications Arch Surg 136 1050–1053 Occurrence Handle1:STN:280:DC%2BD3MrislSisA%3D%3D Occurrence Handle11529829

    CAS  PubMed  Google Scholar 

  5. SP Povoski (2000) ArticleTitleProspective analysis of the cephalic vein cutdown approach for chronic indwelling central venous access in 100 consecutive cancer patients Ann Surg Oncol 7 496–502 Occurrence Handle10.1007/s10434-000-0496-9 Occurrence Handle1:STN:280:DC%2BD3M%2FmtVSjtA%3D%3D Occurrence Handle10947017

    Article  CAS  PubMed  Google Scholar 

  6. A Kamat P Kramer AP Soisson (2002) ArticleTitleCephalic vein cutdown for inserting indwelling subclavian catheters in gynecologic oncology patients WV Med J 98 15–17

    Google Scholar 

  7. RE Schwarz JS Groeger DG Coit (1997) ArticleTitleSubcutaneous implanted central venous access devices in cancer patients: a prospective analysis Cancer 79 1635–1640 Occurrence Handle10.1002/(SICI)1097-0142(19970415)79:8<1635::AID-CNCR30>3.0.CO;2-X Occurrence Handle1:STN:280:ByiB2MfosF0%3D Occurrence Handle9118051

    Article  CAS  PubMed  Google Scholar 

  8. PC Shetty MK Mody DJ Kastan RP Sharma MW Burke C Venugopal TH Burke (1997) ArticleTitleOutcome of 350 implanted chest ports placed by interventional radiologists J Vasc Interv Radiol 8 991–995 Occurrence Handle1:STN:280:DyaK1c%2FmtVeruw%3D%3D Occurrence Handle9399468

    CAS  PubMed  Google Scholar 

  9. KR Simpson DM Hovsepian D Picus (1997) ArticleTitleInterventional radiologic placement of chest wall ports: results and complications in 161 consecutive placements J Vasc Interv Radiol 8 189–195 Occurrence Handle1:STN:280:ByiB3sjltVc%3D Occurrence Handle9083981

    CAS  PubMed  Google Scholar 

  10. MJ Foley (1995) ArticleTitleRadiologic placement of long-term central venous peripheral access system ports (PAS Port): results in 150 patients J Vasc Interv Radiol 6 255–262 Occurrence Handle1:STN:280:ByqA3cnpvFU%3D Occurrence Handle7787360

    CAS  PubMed  Google Scholar 

  11. B Funaki (2002) ArticleTitleCentral venous access: a primer for the diagnostic radiologist AJR 179 309–318 Occurrence Handle12130425

    PubMed  Google Scholar 

  12. H Starkhammar M Bengtsson TB Gain W Galen L Hakansson J Hirsch B Loggie ES Schuman JM Sterchi (1990) ArticleTitleA new injection portal for brachially inserted venous catheter. A multicenter study Med Oncol Tumor Pharmacother 7 281–285 Occurrence Handle1:STN:280:By6C3szgvVE%3D Occurrence Handle2283893

    CAS  PubMed  Google Scholar 

  13. JA Kaufman HS Salamipour SC Geller SM Rivitz AC Waltman (1996) ArticleTitleLong-term outcomes of radiologically placed arm ports Radiology 201 725–730 Occurrence Handle1:STN:280:ByiD1MzmvVE%3D Occurrence Handle8939222

    CAS  PubMed  Google Scholar 

  14. RD Lyon KA Griggs AM Johnson JR Olsen (1999) ArticleTitleLong-term follow-up of upper extremity implanted venous access devices in oncology patients J Vasc Interv Radiol 10 463–471 Occurrence Handle1:STN:280:DyaK1M3ksVCrsA%3D%3D Occurrence Handle10229476

    CAS  PubMed  Google Scholar 

  15. JR Hills JF Cardella K Cardella PN Waybill (1997) ArticleTitleExperience with 100 consecutive central venous access arm ports placed by interventional radiologists J Vasc Interv Radiol 8 983–989 Occurrence Handle1:STN:280:DyaK1c%2FmtVerug%3D%3D Occurrence Handle9399467

    CAS  PubMed  Google Scholar 

  16. LJ Bodner JL Nosher KM Patel RL Siegel R Biswal CE Gribbin R Tokarz (2000) ArticleTitlePeripheral venous access ports: outcomes analysis in 109 patients Cardiovasc Intervent Radiol 23 187–193 Occurrence Handle10.1007/s002700010041 Occurrence Handle1:STN:280:DC%2BD3c3osFeiuw%3D%3D Occurrence Handle10821892

    Article  CAS  PubMed  Google Scholar 

  17. FP Cassidy AB Zajko KM Bron JJ Reilly AB Peitzman DL Steed (1987) ArticleTitleNon infectious complications of long-term central venous catheters: radiologic evaluation and management AJR 149 671–675 Occurrence Handle3498313

    PubMed  Google Scholar 

  18. DF Denny (1993) ArticleTitlePlacement and management of long-term central venous access catheters and ports AJR 161 385–393 Occurrence Handle8333382

    PubMed  Google Scholar 

  19. DD Kidney DT Nguyen LS Deutsch (1998) ArticleTitleRadiologic evaluation and management of malfunctioning long-term central vein catheters AJR 171 1251–1257 Occurrence Handle1:STN:280:DyaK1M%2Fhtlajsg%3D%3D Occurrence Handle9798856

    CAS  PubMed  Google Scholar 

  20. JC Andrews MV Marx DM Williams I Sproat C Walker-Andrews (1992) ArticleTitleThe upper arm approach for placement of peripherally inserted central catheters for protracted venous access AJR 158 427–429 Occurrence Handle1:STN:280:By2C3cbgsFE%3D Occurrence Handle1729802

    CAS  PubMed  Google Scholar 

  21. EP Perry JR Nash AM Klidjian (1990) ArticleTitleDirect cephalic vein cannulation for safe subclavian access J R Coll Surg Edinb 35 218–220 Occurrence Handle1:STN:280:By6D3sfpvFI%3D Occurrence Handle2121966

    CAS  PubMed  Google Scholar 

  22. A Coates CF Dillenbeck DR McNeil SB Kaye K Sims RM Fox RL Woods et al. (1983) ArticleTitleLinear analogue self-assessment (LASA) in evaluation of aspects of the quality of life of cancer patients receiving therapy Eur J Cancer Clin Oncol 19 1633–1637 Occurrence Handle10.1016/0277-5379(83)90096-2 Occurrence Handle1:STN:280:BiuD2Mjpt1M%3D Occurrence Handle6315445

    Article  CAS  PubMed  Google Scholar 

  23. AW Allen JL Megargell DB Brown FC Lynch H Singh Y Singh PN Waybill (2000) ArticleTitleVenous thrombosis associated with the placement of peripherally inserted central catheters J Vasc Interv Radiol 11 1309–1314 Occurrence Handle1:STN:280:DC%2BD3Mzgs1egsw%3D%3D Occurrence Handle11099241

    CAS  PubMed  Google Scholar 

  24. B Burbridge E Krieger G Stoneham (2000) ArticleTitleArm placement of the Cook titanium Petite Vital-Port: results of radiologic placement in 125 patients with cancer Can Assoc Radiol J 51 163–169 Occurrence Handle1:STN:280:DC%2BD3czpt1KlsA%3D%3D Occurrence Handle10914081

    CAS  PubMed  Google Scholar 

  25. C Ballarini M Intra A Pisani Ceretti M Pagani G Farina S Perrone M Tomirotti A Scanni GP Soina (1999) ArticleTitleComplications of subcutaneous infusion port in the general oncology population Oncology 56 97–102 Occurrence Handle10.1159/000011947 Occurrence Handle1:STN:280:DyaK1M7js1Snsg%3D%3D Occurrence Handle9949293

    Article  CAS  PubMed  Google Scholar 

  26. JR Gilsdorf K Wilton TF Beals (1989) ArticleTitleBacterial colonization of intravenous catheter materials in vitro and in vivo Surgery 106 37–44 Occurrence Handle1:STN:280:BiaB1MfmtFI%3D Occurrence Handle2500724

    CAS  PubMed  Google Scholar 

  27. M Brant-Zawadzki M Anthony EC Mercer (1993) ArticleTitleImplantation of a P.A.S. Port venous access device in the forearm under fluoroscopic guidance AJR 160 1127–1128 Occurrence Handle1:STN:280:ByyB38jpvVQ%3D Occurrence Handle8470593

    CAS  PubMed  Google Scholar 

  28. AR Forauer M Alonzo (2000) ArticleTitleChange in peripherally inserted central catheter tip position with abduction and adduction of the upper extremity J Vasc Interv Radiol 11 1315–1318 Occurrence Handle1:STN:280:DC%2BD3Mzgs1egsA%3D%3D Occurrence Handle11099242

    CAS  PubMed  Google Scholar 

  29. SL Morris PF Jaques MA Mauro (1992) ArticleTitleRadiology-assisted placement of implantable subcutaneous infusion ports for long-term venous access Radiology 184 149–151 Occurrence Handle1:STN:280:By2A3c3ltVM%3D Occurrence Handle1609072

    CAS  PubMed  Google Scholar 

  30. B Funaki GX Szymski CA Hackworth JD Rosenblum R Burke T Chang JA Leef (1997) ArticleTitleRadiologic placement of subcutaneous infusion chest ports for long-term venous access AJR 169 1531–1534

    Google Scholar 

  31. SJ Stegman (1976) ArticleTitleGuidelines for placement of elective incisions Cutis 18 723–726 Occurrence Handle1:STN:280:CSiC3sjltlc%3D Occurrence Handle1022420

    CAS  PubMed  Google Scholar 

  32. A Lilienberg M Bengtsson H Starkhammar (1994) ArticleTitleImplantable devices for venous access: nurses’ and patients’ evaluation of three different port systems J Adv Nurs 19 21–28 Occurrence Handle1:STN:280:ByuC1cnmtVw%3D Occurrence Handle8138625

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Radiology Department, Centre Antoine Lacassagne, Nice, France

    P. -Y. Marcy & C. Bailet

  2. Radiotherapy Department, Institut Jules Bordet, 121 Boulevard de Waterloo, Bruxelles, Belgique, 1000

    N. Magné & P. Castadot

  3. Medical Oncology Department, Centre Antoine Lacassagne, Nice, France

    J. -C. Macchiavello

  4. Surgical Department, Centre Antoine Lacassagne, Nice, France

    M. Namer

  5. Radiology Department, Centre Antoine Baclesse, Caen, France

    J. -C. Gallard

Authors
  1. P. -Y. Marcy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. N. Magné
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Castadot
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Bailet
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. -C. Macchiavello
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. Namer
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. J. -C. Gallard
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to N. Magné.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Marcy, P.Y., Magné, N., Castadot, P. et al. Radiological and surgical placement of port devices: a 4-year institutional analysis of procedure performance, quality of life and cost in breast cancer patients. Breast Cancer Res Treat 92, 61–67 (2005). https://doi.org/10.1007/s10549-005-1711-y

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-005-1711-y

Keywords

Search

Navigation