Cancer Research and Treatment

Original Article

A Case-Control Study to Identify Risk Factors for Totally Implantable Central Venous Port-Related Bloodstream Infection: Guk Jin Lee, Sook Hee Hong, Sang Young Roh, Sa Rah Park, Myung Ah Lee, Hoo Geun Chun, Young Seon Hong, Jin Hyoung Kang, Sang Il Kim, Youn Jeong Kim, Ho Jong Chun, Jung Suk Oh; Cancer Res Treat. 2014;46(3):250-260. Published online July 15, 2014; DOI: https://doi.org/10.4143/crt.2014.46.3.250

Purpose
To date, the risk factors for central venous port-related bloodstream infection (CVPBSI) in solid cancer patients have not been fully elucidated. We conducted this study in order to determine the risk factors for CVP-BSI in patients with solid cancer.
Materials and Methods
A total of 1,642 patients with solid cancer received an implantable central venous port for delivery of chemotherapy between October 2008 and December 2011 in a single center. CVP-BSI was diagnosed in 66 patients (4%). We selected a control group of 130 patients, who were individually matched with respect to age, sex, and catheter insertion time.
Results
CVP-BSI occurred most frequently between September and November (37.9%). The most common pathogen was gram-positive cocci (n=35, 53.0%), followed by fungus (n=14, 21.2%). Multivariate analysis identified monthly catheter-stay as a risk factor for CVP-BSI (p=0.000), however, its risk was lower in primary gastrointestinal cancer than in other cancer (p=0.002). Initial metastatic disease and long catheter-stay were statistically significant factors affecting catheter life span (p=0.005 and p=0.000). Results of multivariate analysis showed that recent transfusion was a risk factor for mortality in patients with CVP-BSI (p=0.047).
Conclusion
In analysis of the results with respect to risk factors, prolonged catheter-stay should be avoided as much as possible. It is necessary to be cautious of CVP-BSI in metastatic solid cancer, especially non-gastrointestinal cancer. In addition, avoidance of unnecessary transfusion is essential in order to reduce the mortality of CVP-BSI. Finally, considering the fact that confounding factors may have affected the results, conduct of a well-designed prospective controlled study is warranted.

Citations

Citations to this article as recorded by

Risk Factors of the Totally Implantable Venous Access Device-Related Infection in Patients With Brain Tumors Undergoing Chemotherapy After Surgery
Haihong Li, Jing Shan
Surgical Infections.2024; 25(2): 133. CrossRef
An analysis of totally implantable central venous port system infections in an urban tertiary referral center
Ulrich Krümpelmann, Ahmed Boseila, Mathias Löhnert, Olaf Kaup, Jacob J. Clarenbach, Martin Görner
Journal of Chemotherapy.2021; 33(4): 228. CrossRef
Use of catheter with 2-methacryloyloxyethyl phosphorylcholine polymer coating is associated with long-term availability of central venous port
Yuuki Iida, Kumiko Hongo, Takanobu Onoda, Yusuke Kita, Yukio Ishihara, Naoki Takabayashi, Ryo Kobayashi, Takeyuki Hiramatsu
Scientific Reports.2021;[Epub] CrossRef
Clinical Characteristics and Risk Factors of Long-term Central Venous Catheter–associated Bloodstream Infections in Children
Hye Min Moon, Suji Kim, Ki Wook Yun, Hyun-young Kim, Sung Eun Jung, Eun Hwa Choi, Hoan Jong Lee
Pediatric Infectious Disease Journal.2018; 37(5): 401. CrossRef
Risk factors for health care–associated infection in hospitalized adults: Systematic review and meta-analysis
Alba Luz Rodríguez-Acelas, Miriam de Abreu Almeida, Bruna Engelman, Wilson Cañon-Montañez
American Journal of Infection Control.2017; 45(12): e149. CrossRef
WITHDRAWN: Prevention of peripherally inserted central catheter-related infections in very low-birth-weight infants by using a central line bundle guideline with a standard checklist
Chen Yuan, Qing Zhao, Xiaoyan Song, Fei Meng
International Journal of Nursing Sciences.2016; 3(1): 50. CrossRef
Prevention of peripherally inserted central line-associated blood stream infections in very low-birth-weight infants by using a central line bundle guideline with a standard checklist: a case control study
Wei Wang, Chunling Zhao, Qinglian Ji, Ying Liu, Guirong Shen, Lili Wei
BMC Pediatrics.2015;[Epub] CrossRef
Central venous access in oncology: ESMO Clinical Practice Guidelines
B. Sousa, J. Furlanetto, M. Hutka, P. Gouveia, R. Wuerstlein, J.M. Mariz, D. Pinto, F. Cardoso
Annals of Oncology.2015; 26: v152. CrossRef
Port type is a possible risk factor for implantable venous access port-related bloodstream infections and no sign of local infection predicts the growth of gram-negative bacilli
Jui-Feng Hsu, Hsu-Liang Chang, Ming-Ju Tsai, Ying-Ming Tsai, Yen-Lung Lee, Pei-Huan Chen, Wen-Chieh Fan, Yu-Chung Su, Chih-Jen Yang
World Journal of Surgical Oncology.2015;[Epub] CrossRef

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Case Report

A Case of Extraskeletal Ewing's Sarcoma Arising from Duodenum: Sang Il Kim, Yeon Hee Park, Seong Jun Choi, Baek Yeol Ryoo, Seung Sook Lee, Hyun Bae Son, Yo Ahn Suh, Dae Han Kim, Sung Ho Kim, Kui Sung Choi, Yoong Ju Kweon; Cancer Res Treat. 2002;34(6):461-465. Published online December 31, 2002; DOI: https://doi.org/10.4143/crt.2002.34.6.461

Abstract PDF

Extraskeletal Ewing's sarcomas (EES) are rare. Recently, Ewing's sarcoma of the bone, primitive neuroectodermal tumor (PNET), Askin tumor and EES have been included into the family of Ewing's tumors, due to the overlapping features relating to their clinico-pathological and cytogenetic appearance. We experienced a case of an EES arising from the duodenum in a 14-year-old girl who presented with hematemesis and epigastric discomfort. A duodenal biopsy specimen revealed the infiltration of small round cells and rich vasculatures, with immunohistochemical finding of MIC-2 (CD99) (+), vimentin (+), CD56 (NCAM) (+), LCA (-), T-cell (-), B-cell (-), CD43 (-) and CD68 (-). She was treated with several cycles of multiagent chemotherapy, and achieved an initial partial response, but rapid progression of tumor followed, so she was treated with surgical excision. This is the first case report of an EES arising from the duodenum in the literature.

Citations

Citations to this article as recorded by

Ewing’s sarcoma of the duodenum: a rare clinical condition managed with surgical resection
Saniya Saiyed, Omar A Mownah, Matthew J Bowles, Aditya Kanwar
BMJ Case Reports.2023; 16(6): e249686. CrossRef

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1 Crossref

Original Article

The Effect of Intensified Induction Using Vanderbilt Regimen in Patients with an Intermediate Grade Non-Hodgkin's Lymphoma Having 2 or 3 Adverse Factors on the Age-adjusted International Prognostic Index: Yoong Ju Kweon, Seong Jun Choi, Baek Yeol Ryoo, Yeon Hee Park, Bong Seog Kim, Dae Han Kim, Sang Il Kim, Sung Ho Kim, Yo Ahn Suh, Hyun Bae Son, Kui Sung Choi, Seung Sook Lee, Yoon Koo Kang; Cancer Res Treat. 2002;34(5):326-333. Published online October 31, 2002; DOI: https://doi.org/10.4143/crt.2002.34.5.326

Abstract PDF: PURPOSE
The purpose of our study was to evaluate the outcome of intensified induction therapy using the Vanderbilt regimen in patients with a poor prognosis non-Hodgkin's lymphoma (NHL).
MATERIALS AND METHODS
We retrospectively analyzed the results of two pilot studies, which enrolled the patients aged 60 years or less, with a previously untreated NHL of intermediate grade on the Working formulation, having 2 or 3 adverse prognostic factors on the age- adjusted International Prognostic Index. Patients received an intensified induction, with the regimen described by the Vanderbilt group.
RESULTS
Thirty-five patients were analyzed. After induction, 29 patients (83%) achieved more than partial response (PR): 22 (63%) complete response (CR) and 7 (20%) PR. Three of the PRs were subsequently converted to CR following consolidation therapy. The overall CR rate, following the completion of treatment, was 71%. The 3-year overall survival (OS) rate of all patients was 53%. In the univariate analysis, age (50 years) was the only factor affecting the OS. The 3-year disease-free survival (DFS) rate of patients with CR was 68%. In the univariate analysis, age and bone marrow involvement were the factors affecting the DFS. Two patients died from the treatment-related toxicity of the induction therapy: one due to sepsis and the other due to congestive heart failure.
CONCLUSION
Although the CR rate was relatively high, the OS or DFS of patients with a poor prognosis NHL, who had received the intensified induction using the Vanderbilt regimen, were no different from those that had received the conventional chemotherapy, as reported by the International Prognostic Index Project. However, the OS or DFS in the young patient groups were encouraging. To test the hypothesized benefits of our approach in the young patient groups, a larger cohort of patients aged 50 years or less should be studied.

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