Abstract

ABSTRACT Aim: Adjuvant chemotherapy is indicated for patients treated for early breast cancer with poor prognostic factors. Central venous device is required for this administration. Both Port catheter and Peripherally Inserted Central Catheters (PICC) are routinely used even if no comparison between these devices is available in this setting. Methods: All patients treated from January 2010 to August 2012 at the Centre Henri Becquerel for an early breast cancer requiring a post-operative chemotherapy (6 FEC or 3 FEC + 3 TXT) were retrospectively screened. Patients with a Her2 overexpression were excluded. The type of central venous device (port or PICC), age, BMI, type of surgery or node exploration, chemotherapy regimen and complications induced by central venous catheter were collected. The primary endpoint was the probability of occurrence of a major complication related to the central venous device. Majors complications were defined as: any grade 3 event according to CTCAE 4.0, delay in chemotherapy >7 days, change of the device, life-threatening event, hospitalization or prolongation of hospitalization. Analysis was performed by a Kaplan-Meier and a Cox model. Results: 448 patients were included: 290 (65%) had a port and 158 (35%) a PICC. Among the 448 patients, 31 (6.9%) had at least one major complication related to the device: 13 for patients with a port (4.5%) and 18 for patients with a PICC (11.4%). The most frequent complication was a thromboembolic event. In univariate analysis, having a PICC was the only factor significantly associated with a higher risk of complications (HR = 2.83, p = 0.0027). There was a trend for more complications for patients with a BMI > 25 (HR = 2.04, p = 0.056) or older than 60 years (HR = 1.95, p = 0.057). In multivariate analysis, having a PICC was the only predictive factor of complications (HR = 2.89, p = 0.0036). Conclusions: In univariate and multivariate analysis, having a PICC instead of a port as central venous device was the only predictive factor of device related major complication. If confirmed prospectively by the NCT02095743 ongoing trial, this result may modify the management of adjuvant chemotherapy administration. Disclosure: All authors have declared no conflicts of interest.

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