{"title":"何时切除可植入血管通路？回顾性分析376例乳腺癌患者植入式血管通路。","authors":"Jun Luo, Zheng Yao, Weiren Liang, Gu Zhao, Jiaping Zheng, Yuwei Liu, Zifang Jiang, Xinyan Yu","doi":"10.1186/s12893-025-03173-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"420"},"PeriodicalIF":1.8000,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495737/pdf/","citationCount":"0","resultStr":"{\"title\":\"When to remove implantable vascular access ports? a retrospective analysis of 376 patients with breast cancer and implantable vascular access ports.\",\"authors\":\"Jun Luo, Zheng Yao, Weiren Liang, Gu Zhao, Jiaping Zheng, Yuwei Liu, Zifang Jiang, Xinyan Yu\",\"doi\":\"10.1186/s12893-025-03173-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>\",\"PeriodicalId\":49229,\"journal\":{\"name\":\"BMC Surgery\",\"volume\":\"25 1\",\"pages\":\"420\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-10-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495737/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12893-025-03173-4\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12893-025-03173-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
背景：肿瘤患者植入式血管通道（ports）的最佳切除时间尚不清楚。本研究旨在探讨乳腺癌患者2年内PORT切除的时机及PORT切除的影响。方法：本回顾性研究纳入2012年7月至2022年5月在我院行PORT植入术并最终切除PORT的乳腺癌患者。生活质量评分采用Karnofsky法。主要终点为生活质量（QoL） (A: 80-100分，基本正常自理能力；B: 60-79分，轻度自理能力依赖；C：结果：本研究纳入376例女性患者，中位年龄52岁（范围22-72岁）。PORT留置时间中位数为464天（范围16-2717天）。PORT留置时间≤2年与>2年患者的生活质量评分差异无统计学意义[A/B/C: 90.87%/7.94%/1.19%对95.97%/4.03%/0,P = 0.185]。PORT留置时间≤2年的患者出现意外拔管的概率较高（16.76% vs. 3.99%，优势比= 2.42,P = 0.004），二次置管率较高（28.99% vs. 3.72%，优势比= 5.08,P = 0.004），医疗费用较高（24.57±31.36 vs. 7.16±1.19元/天，P 2年）。两组并发症发生率比较，差异无统计学意义（P = 0.751）。在计划取出PORT的患者亚组中，≤2年组的二次置管率仍明显高于对照组（31.22% vs. 8.26%）。P结论：对于不需要定期静脉给药的乳腺癌患者，建议考虑在2年后取出输注端口，以降低二次置管的风险，降低医疗费用，除非不可逆的不良事件影响PORT的正确使用。临床试验号：不适用。
When to remove implantable vascular access ports? a retrospective analysis of 376 patients with breast cancer and implantable vascular access ports.
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.
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