Brief Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Oct 7, 2009; 15(37): 4709-4714
Published online Oct 7, 2009. doi: 10.3748/wjg.15.4709
Analysis of risk factors for central venous port failure in cancer patients
Ching-Chuan Hsieh, Hsu-Huei Weng, Wen-Shih Huang, Wen-Ke Wang, Chiung-Lun Kao, Ming-Shian Lu, Chia-Siu Wang
Ching-Chuan Hsieh, Wen-Shih Huang, Wen-Ke Wang, Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan, China; Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, China
Hsu-Huei Weng, Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan, China
Wen-Shih Huang, Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan, China
Chiung-Lun Kao, Ming-Shian Lu, Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan, China
Chia-Siu Wang, Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan, China
Author contributions: Hsieh CC, Wang WK, Huang WS and Wang CS designed and performed the research; Kao CL and Lu MS provided the data; Weng HH analyzed the data; Hsieh CC wrote the paper.
Correspondence to: Ching-Chuan Hsieh, MD, Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan, China. jeffrey570404@gmail.com
Telephone: +886-5-3621000 Fax: +886-5-3623002
Received: July 28, 2009
Revised: August 24, 2009
Accepted: August 31, 2009
Published online: October 7, 2009
Abstract

AIM: To analyze the risk factors for central port failure in cancer patients administered chemotherapy, using univariate and multivariate analyses.

METHODS: A total of 1348 totally implantable venous access devices (TIVADs) were implanted into 1280 cancer patients in this cohort study. A Cox proportional hazard model was applied to analyze risk factors for failure of TIVADs. Log-rank test was used to compare actuarial survival rates. Infection, thrombosis, and surgical complication rates (χ2 test or Fisher’s exact test) were compared in relation to the risk factors.

RESULTS: Increasing age, male gender and open-ended catheter use were significant risk factors reducing survival of TIVADs as determined by univariate and multivariate analyses. Hematogenous malignancy decreased the survival time of TIVADs; this reduction was not statistically significant by univariate analysis [hazard ratio (HR) = 1.336, 95% CI: 0.966-1.849, P = 0.080)]. However, it became a significant risk factor by multivariate analysis (HR = 1.499, 95% CI: 1.079-2.083, P = 0.016) when correlated with variables of age, sex and catheter type. Close-ended (Groshong) catheters had a lower thrombosis rate than open-ended catheters (2.5% vs 5%, P = 0.015). Hematogenous malignancy had higher infection rates than solid malignancy (10.5% vs 2.5%, P < 0.001).

CONCLUSION: Increasing age, male gender, open-ended catheters and hematogenous malignancy were risk factors for TIVAD failure. Close-ended catheters had lower thrombosis rates and hematogenous malignancy had higher infection rates.

Keywords: Central venous port; Chemotherapy; Risk factor; Cancer patient; Multivariate analysis