Is There a Relationship Between Frequency of Port-Care Maintenance and Related Complications in Patients With Cancer?

PURPOSE: Totally implantable ports require regular maintenance to prevent port-related complications. Manufacturers recommend monthly maintenance port flushes for patients for the life of the port. Previous studies show that extending intervals between maintenance port flushes up to 16 weeks does not increase incidence of port-related complications. To date, no prospective study has been conducted to evaluate the medical safety of extending flush intervals from monthly to every 12 weeks within a heterogeneous disease cohort. Research Question: Is it feasible and medically safe to extend intervals between maintenance port flushes to every 12 weeks in patients with cancer not on active treatment? PATIENTS AND METHODS: This study enrolled oncology and hematology patients who had retained their port following completion of anticancer treatment. Clinical data were extracted for 1,059 participants. The primary end points of this study were the overall number of ports removed and incidence of port-related complications reported between cohorts 1 and 2 (flushes every 4-8 weeks), and cohort 3 (flushes every 12 weeks). RESULTS: Data were allocated into three study cohorts on the basis of year and duration between port flushes. No difference was observed in the overall percentage of ports removed because of physician-reported complications across all cohorts (25%-30%). No change in the incidence of port-related complications including suspected infection and malfunction was observed between cohorts 1 and 2 (8%), or cohort 3 (5%). CONCLUSION: Our findings show that extending maintenance port flush intervals to 12 weeks does not increase the incidence of port-related adverse events and is medically safe.

[1]  A. Bodenham,et al.  Central venous access devices for the delivery of systemic anticancer therapy (CAVA): a randomised controlled trial , 2021, The Lancet.

[2]  K. Chìn,et al.  Clinical utility of polyethylene glycol conjugated granulocyte colony-stimulating factor (PEG-G-CSF) for preventing severe neutropenia in metastatic colorectal cancer patients treated with FOLFOXIRI plus bevacizumab: a single-center retrospective study , 2020, BMC Cancer.

[3]  W. Schima,et al.  Complications of central venous port systems: a pictorial review , 2019, Insights into Imaging.

[4]  Hossam Abdel Rahman,et al.  Efficacy of primary prophylactic GCSF in patients receiving docetaxel based chemotherapy for breast cancer. , 2018 .

[5]  D. Lebeaux,et al.  Removal of totally implanted venous access ports for suspected infection in the intensive care unit: a multicenter observational study , 2018, Annals of Intensive Care.

[6]  C. Johnstone,et al.  Bleeding in cancer patients and its treatment: a review. , 2018, Annals of palliative medicine.

[7]  S. Rai,et al.  Phase II Trial on Extending the Maintenance Flushing Interval of Implanted Ports. , 2017, Journal of oncology practice.

[8]  J. Cata,et al.  Blood transfusion practices in cancer surgery , 2014, Indian journal of anaesthesia.

[9]  E. Moraes,et al.  Safety of every 90 days portacath heparin maintenance flush in patients with cancer. , 2014 .

[10]  N. Zengi̇n,et al.  Effect of port-care frequency on venous port catheter-related complications in cancer patients , 2014, International Journal of Clinical Oncology.

[11]  M. Gorman,et al.  Central venous catheter care for the patient with cancer: American Society of Clinical Oncology clinical practice guideline. , 2013, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[12]  L. Rasero,et al.  The late complications of totally implantable central venous access ports: the results from an Italian multicenter prospective observation study. , 2011, European journal of oncology nursing : the official journal of European Oncology Nursing Society.

[13]  Sanjay Saint,et al.  Guidelines for the prevention of intravascular catheter-related infections. , 2011, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[14]  C. Drenzek,et al.  Catheter-Related Polymicrobial Bloodstream Infections among Pediatric Bone Marrow Transplant Outpatients—Atlanta, Georgia, 2007 , 2010, Infection Control & Hospital Epidemiology.

[15]  T. Ignatov,et al.  Interval between Port Catheter Flushing Can Be Extended to Four Months , 2010, Gynecologic and Obstetric Investigation.

[16]  S. Loibl,et al.  Management of venous port systems in oncology: a review of current evidence. , 2008, Annals of oncology : official journal of the European Society for Medical Oncology.

[17]  M. Krzakowski,et al.  Totally implantable central venous access ports , 2006 .

[18]  A. Fields,et al.  How Often Should a Port-A-Cath be Flushed? , 2005, Cancer investigation.

[19]  W. Haire,et al.  Are clinical signs accurate indicators of the cause of central venous catheter occlusion? , 1995, JPEN. Journal of parenteral and enteral nutrition.