Cancer Management and Research (May 2024)

Risk Factors for Unplanned Early Implantable Port Catheter Removal in Adult Hematology Cancer Patients Receiving Chemotherapy: A Propensity Score Matching Study

  • Lu MS,
  • Chen CC,
  • Chang CC,
  • Lin CC,
  • Hsieh CC

Journal volume & issue
Vol. Volume 16
pp. 445 – 454

Abstract

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Ming-Shian Lu,1,2 Chih-Chen Chen,2,3 Che-Chia Chang,1 Chien-Chao Lin,1 Ching-Chuan Hsieh1,2 1Department of Surgery, Chang Gung Memorial Hospital at Chiayi, Puzi City, Taiwan; 2Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; 3Department of Medicine, Chang Gung Memorial Hospital at Chiayi, Puzi City, TaiwanCorrespondence: Ching-Chuan Hsieh, Department of Surgery, Chang Gung Memorial Hospital at Chiayi, 8, West Sec, Jiapu Road, Puzi City, Chiayi, 613016, Taiwan, Tel +886 5 362100 Ext 2860, Fax +886- 5 3623002, Email [email protected]: Implantable port catheter is a reliable vascular access for chemotherapy infusion in cancer patients. However, patients with hematology malignancies usually present with a myriad of blood cell abnormalities that put them at risk of infection and mechanical problems requiring catheter removal. This study aims to determine the risk factors associated with unplanned (catheter removal other than completion of treatment plan) early (within 90 days of catheter implantation) implantable port catheter removal.Patients and Methods: A retrospective, propensity score-matched study of 386 patients with hematology malignancies who received implantable venous access ports between January 2015 and December 2022. We conducted a univariate analysis to select the variables for propensity score matching. Patients with unplanned early implantable port catheter removal (early group) were matched 1:1 to patients without unplanned early removal (non-early group).Results: Univariate analysis demonstrated a statistically significant difference between early and non-early groups for age (p = 0.048), hemoglobin level (p = 0.028), thrombocytopenia (p = 0.025), and PG-SGA (p < 0.001). Thrombocytopenia was the only independent risk factor with a statistically significant difference in Cox proportional hazard analysis, HR 2.823, 95 CI 1.050– 7.589, p = 0.040. The median catheter survival for patients with thrombocytopenia was 61 days (95% CI 28.58– 93.42) compared to 150 days (95% CI 9.81– 290.19) for patients without thrombocytopenia, p = 0.015. Patient survival is not affected by early catheter removal. The median survival for patients in the early group was 28.28 months (95% CI 27.43– 29.15) compared to 32.39 months (95% CI 24.11– 40.68), for the non-early group, p = 0.709.Conclusion: Hematology malignancy patients with thrombocytopenia are at high risk for unplanned early port catheter removal without survival difference.Keywords: hematology, malignancy, vascular port, risk factors, explanation

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