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01.03.2016 | Original Article

Port catheter versus peripherally inserted central catheter for postoperative chemotherapy in early breast cancer: a retrospective analysis of 448 patients

verfasst von: L. Lefebvre, E. Noyon, D. Georgescu, V. Proust, C. Alexandru, M. Leheurteur, J. C. Thery, L. Savary, O. Rigal, F. Di Fiore, C. Veyret, F. Clatot

Erschienen in: Supportive Care in Cancer | Ausgabe 3/2016

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Abstract

Purpose

We aimed to compare the complication rate between port catheters (PC) and peripherally inserted central catheters (PICC) for the administration of postoperative chemotherapy for breast cancer.

Methods

All patients treated from January 2010 to August 2012 at the Centre Henri Becquerel for early breast cancer requiring postoperative chemotherapy were retrospectively screened. The primary endpoint was the occurrence of a major complication related to the central venous catheter. Major complications were defined as any grade 3 event according to CTCAE 4.0, delay in chemotherapy >7 days, change of the device, life-threatening event, event requiring a hospitalization, or a prolongation of hospitalization.

Results

A total of 448 patients were included; 290 had a PC and 158 a PICC. Overall, 31 major complications related to the central venous catheter were observed: 13 for patients with a PC (4.5 %) and 18 for patients with a PICC (11.4 %). In univariate analysis, having a PICC was the only factor significantly associated with a higher risk of major complications (HR = 2.83, p = 0.0027). We observed a trend for a higher risk of major complications for patients older than 60 years or with BMI >25 (p = 0.06). In multivariate analysis, having a PICC was the only predictive factor of major complications (HR = 2.89, p = 0.004).

Conclusions

In univariate and multivariate analysis, having a PICC instead of a PC was the only predictive factor of device-related major complication. If confirmed prospectively by the NCT02095743 ongoing trial, this result might modify the management of adjuvant chemotherapy administration.

Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J et al (2013) Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer 1990 49(6):1374–1403

Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), Peto R, Davies C, Godwin J et al (2012) Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials. Lancet 79:432–44CrossRef

Roché H, Fumoleau P, Spielmann M et al (2006) Sequential adjuvant epirubicin-based and docetaxel chemotherapy for node-positive breast cancer patients: the FNCLCC PACS 01 Trial. J Clin Oncol 24:5664–5671CrossRefPubMed

Ng PK, Ault MJ, Maldonado LS (1996) Peripherally inserted central catheters in the intensive care unit. J Intensive Care Med 11:49–54CrossRefPubMed

Thiagarajan RR, Ramamoorthy C, Gettmann T, Bratton SL (1997) Survey of the use of peripherally inserted central venous catheters in children. Pediatrics 99:E4CrossRefPubMed

Bottino J, McCredie KB, Groschel DHM, Lawson M (1979) Long-term intravenous therapy with peripherally inserted silicone elastomer central venous catheters in patients with malignant diseases. Cancer 43:1937–1943CrossRefPubMed

Strahilevitz J, Lossos IS, Verstandig A et al (2001) Vascular access via peripherally inserted central venous catheters (PICCs): experience in 40 patients with acute myeloid leukemia at a single institute. Leuk Lymphoma 40:365–371CrossRefPubMed

Walshe LJ, Malak SF, Eagan J, Sepkowitz KA (2002) Complication rates among cancer patients with peripherally inserted central catheters. J Clin Oncol 20:3276–3281CrossRefPubMed

Chopra V, Anand S, Hickner A et al (2013) Risk of venous thromboembolism associated with peripherally inserted central catheters: a systematic review and meta-analysis. Lancet 382:311–325CrossRefPubMed

10.

Saber W, Moua T, Williams EC et al (2011) Risk factors for catheter-related thrombosis (CRT) in cancer patients: a patient-level data (IPD) meta-analysis of clinical trials and prospective studies. J Thromb Haemost 9:312–319PubMedCentralCrossRefPubMed

11.

Cheong K, Perry D, Karapetis C, Koczwara B (2004) High rate of complications associated with peripherally inserted central venous catheters in patients with solid tumours. Intern Med J 34:234–238CrossRefPubMed

12.

Ye X, Wong SW, Zhang J, Moo, IH et al (2014) Catheter-related upper limb venous thrombosis in a tertiary hospital setting. ANZ J Surg

13.

Kim HJ, Yun J, Kim HJ et al (2010) Safety and effectiveness of central venous catheterization in patients with cancer: prospective observational study. J Korean Med Sci 25:1748PubMedCentralCrossRefPubMed

14.

Patel GS, Jain K, Kumar R et al (2014) Comparison of peripherally inserted central venous catheters (PICC) versus subcutaneously implanted port-chamber catheters by complication and cost for patients receiving chemotherapy for non-haematological malignancies. Support Care Cancer 22:121–128CrossRefPubMed

15.

Schiffer CA, Mangu PB, Wade JC et al (2013) Central venous catheter care for the patient with cancer: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol 31:1357–1370CrossRefPubMed

16.

Khavanin N, Gart MS, Berry T et al (2013) Sentinel lymph node biopsy versus axillary lymphadenectomy in patients treated with lumpectomy: an analysis of short-term outcomes. Ann Surg Oncol 21:74–80CrossRefPubMed

17.

Bafford A, Gadd M, Gu X et al (2010) Diminishing morbidity with the increased use of sentinel node biopsy in breast carcinoma. Am J Surg 200:374–377CrossRefPubMed

18.

Chew HK, Wun T, Harvey D et al (2006) Incidence of venous thromboembolism and its effect on survival among patients with common cancers. Arch Intern Med 166:458–464CrossRefPubMed

19.

Baron JA, Gridley G, Weiderpass E et al (1998) Venous thromboembolism and cancer. Lancet 351:1077–1080CrossRefPubMed

20.

Petterson TM, Marks RS, Ashrani AA et al (2015) Risk of site-specific cancer in incident venous thromboembolism: a population-based study. Thromb Res 135:472–478CrossRefPubMed

21.

Xing L, Adhikari VP, Liu H et al (2012) Diagnosis prevention and treatment for PICC-related upper extremity deep vein thrombosis in breast cancer patients. Asia Pac J Clin Oncol 8:e12–e16CrossRefPubMed

22.

Hanna H, Benjamin R, Chatzinikolaou I et al (2004) Long-term silicone central venous catheters impregnated with minocycline and rifampin decrease rates of catheter-related bloodstream infection in cancer patients: a prospective randomized clinical trial. J Clin Oncol 22:3163–3171CrossRefPubMed

23.

Darouiche RO, Berger DH, Khardori N et al (2005) Comparison of antimicrobial impregnation with tunneling of long-term central venous catheters: a randomized controlled trial. Ann Surg 242:193–200PubMedCentralCrossRefPubMed

24.

Van de Wetering MD, van Woensel JB (1996) Prophylactic antibiotics for preventing early central venous catheter Gram positive infections in oncology patients. Cochrane Database of Systematic Reviews

25.

Couban S, Goodyear M, Burnell M et al (2005) Randomized Placebo-Controlled Study of Low-Dose Warfarin for the Prevention of Central Venous Catheter–Associated Thrombosis in Patients With Cancer. J Clin Oncol 23:4063–4069CrossRefPubMed

26.

Verso M, Agnelli G, Bertoglio S et al (2005) Enoxaparin for the prevention of venous thromboembolism associated with central vein catheter: a double-blind, placebo-controlled, randomized study in cancer patients. J Clin Oncol 23:4057–4062CrossRefPubMed

27.

Young AM, Billingham LJ, Begum G et al (2009) Warfarin thromboprophylaxis in cancer patients with central venous catheters (WARP): an open-label randomised trial. Lancet 373:567–574CrossRefPubMed

28.

Karthaus M, Kretzschmar A, Kröning H et al (2006) Dalteparin for prevention of catheter-related complications in cancer patients with central venous catheters: final results of a double-blind, placebo-controlled phase III trial. Ann Oncol 17:289–296CrossRefPubMed

29.

Akl EA, Ramly EP, Kahale LA et al (2014) Anticoagulation for people with cancer and central venous catheters. Cochrane Database Syst Rev 10:CD006468PubMed

30.

Caine GJ, Stonelake PS, Rea D, Lip GYH (2003) Coagulopathic complications in breast cancer. Cancer 98:1578–1586CrossRefPubMed

31.

Lee AYY, Levine MN, Butler G et al (2006) Incidence, risk factors, and outcomes of catheter-related thrombosis in adult patients with cancer. J Clin Oncol 24:1404–1408CrossRefPubMed

32.

Yap Y-S, Karapetis C, Lerose S et al (2006) Reducing the risk of peripherally inserted central catheter line complications in the oncology setting. Eur J Cancer Care 15:342–347CrossRef

Titel: Port catheter versus peripherally inserted central catheter for postoperative chemotherapy in early breast cancer: a retrospective analysis of 448 patients
verfasst von: L. Lefebvre
E. Noyon
D. Georgescu
V. Proust
C. Alexandru
M. Leheurteur
J. C. Thery
L. Savary
O. Rigal
F. Di Fiore
C. Veyret
F. Clatot
Publikationsdatum: 01.03.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 3/2016
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-015-2901-8

Springer Medizin

Port catheter versus peripherally inserted central catheter for postoperative chemotherapy in early breast cancer: a retrospective analysis of 448 patients