Abstract:
Background: Most patients with advanced malignancies require chemotherapy as a fundamental component of treatment. A durable venous access device is essential to facilitate the repeated administration of chemotherapeutic agents. However, there is relatively limited research on the selection of optimal access methods. No single access method has shown clear superiority, leading to varying preferences for different central venous access devices. Therefore, we aimed to compare the chemoport and Hickman central venous catheters (CVCs) as representative devices used in patients with hematological cancer.
Methods: This single-center retrospective study included 653 patients with hematological cancers among 2,113 patients with advanced cancer who underwent CVC insertion at the Department of Thoracic and Cardiovascular Surgery between January 1, 2014, and December 31, 2022.
Results: In total, 280 patients underwent chemoport insertion, and 373 patients underwent Hickman catheter insertion. The mean maintenance duration of the chemoport group was longer than that of the Hickman group (366.30±367.48 vs. 168.33±118.76 days; P<0.001). Consequently, the reinsertion rate was significantly higher in the Hickman group (1.64±0.94 vs. 1.19±0.55, P<0.001). The infection incidence rate of the Hickman group was higher than that of the chemoport group [14.2% (n=53) vs. 6.1% (n=17), P<0.001]. The two groups showed no statistically significant differences in the incidence of thrombosis (0.8% vs. 2.1%, P=0.13).
Conclusions: For immunocompromised patients with hematological malignancies, chemoport usage may reduce the occurrence of infections, ensuring the long-term maintenance of vascular access. Furthermore, the average reinsertion rate of both groups was confirmed to be more than 1. Therefore, performing the stem cell transplantation procedure using Hickman CVC and then changing to chemoport for subsequent chemotherapy can minimize the infection risk and safely preserve long-term vascular access. Additionally, the overall complication rate can be reduced through accurate CVC insertion methods using vascular imaging and routine management by medical professionals.
Reference:Han C, Kim GM, Shin HJ, Kim DY, Lee CW, Bae M, Kim JW, Park JH, Lee J, Huh U. Comparison of chemoport and Hickman central venous catheters in patients with hematological cancer. Transl Cancer Res. 2025 Apr 30;14(4):2290-2302. doi: 10.21037/tcr-24-2147. Epub 2025 Apr 7. PMID: 40386275; PMCID: PMC12079257.