When to remove implantable vascular access ports? a retrospective analysis of 376 patients with breast cancer and implantable vascular access ports.

Abstract

Background: The optimal timing of removal of implanted vascular access ports (PORTs) in cancer patients is unknown. This study aimed to explore the timing of PORT removal and the impact of PORT removal within 2 years in breast cancer patients.

Methods: This retrospective study included breast cancer patients who underwent PORT implantation at our Hospital between July 2012 and May 2022 and ultimately had their PORTs removed. QoL scores were assessed using the Karnofsky method. The primary endpoint was quality of life (QoL) (A: 80-100 points, basically normal self-care ability; B: 60-79 points, mild dependence on self-care ability; C: <60 points, moderate to severe dependence). The secondary endpoints included the proportion of unplanned PORT removal, secondary catheterization, medical costs, and complications.

Results: This study included 376 female patients with a median age of 52 (range, 22-72) years. The median PORT indwelling time was 464 (range, 16-2717) days. No significant differences were observed in the QoL scores between patients with PORT indwelling time ≤ 2 vs. >2 years [A/B/C: 90.87%/7.94%/1.19% vs. 95.97%/4.03%/0, P = 0.185]. Patients with PORT indwelling time ≤ 2 years exhibited higher probabilities of unplanned port removal (16.76% vs. 3.99%, odds ratio = 2.42, P = 0.004), higher secondary catheterization (28.99% vs. 3.72%, odds ratio = 5.08, P = 0.004), and higher medical costs (24.57 ± 31.36 vs. 7.16 ± 1.19 CNY/day, P < 0.001) compared with patients with PORT indwelling time > 2 years. There were no significant differences in the frequency of complications between groups (P = 0.751). In the subgroup of patients with planned PORT removal, the ≤ 2-year group still showed significantly higher secondary catheterization rates (31.22% vs. 8.26%, P < 0.001) and daily costs (14.83 vs. 6.83 CNY/day, P < 0.001).

Conclusion: In patients with breast cancer who do not require regular intravenous administration, it may be recommended to consider removing the infusion port after 2 years to reduce the risks of secondary catheterization and reduce medical costs, unless irreversible adverse events affect the correct use of the PORT.

Clinical trial number: Not applicable.