Si-Yi Peng1, Tao Wei2, Xu-Ying Li3, Zhong Yuan4, Qin Lin4. 1. The Early Clinical Trial Center in The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan Province, China. 2. Anesthesiology Department, Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, 283 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan Province, China. 3. Anesthesiology Department, Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, 283 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan Province, China. lixuying@hnca.org.cn. 4. Vascular Access Clinic, Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan Province, China.
Abstract
PURPOSE: Limited risk assessment tool to stratify the risk of PICC-related thrombosis (PICC-RVT) in breast cancer patients. This study developed a model to assess the risk of PICC-RVT in breast cancer patients. METHODS: We conducted a retrospective cohort study of 1284 breast cancer patients receiving PICC insertion from January 1, 2015, to August 31, 2019, at a cancer specialized hospital in Hunan province, China. The entire population was divided into two groups at a ratio of 3:1 which included a derivation sample (n = 978), and a validation sample (n = 284). PICC-RVT was confirmed by ultrasonography in the presence of clinical symptoms and signs. RESULTS: PICC-RVT occurred in 40 (4.09%) of the derivation sample patients. Multivariable analysis identified 9 variables: chronic obstructive pulmonary disease, prior central venous catheter placement, higher level of platelets, higher level of D-dimer, lower level of activated partial thromboplastin time, menopause, no prior breast surgery, upper extremity lymphedema, and endocrine therapy. Points were assigned to each variable according to regression coefficient. The model had an area under the receiver operating characteristics curve (AUC) of 0.850 (95% CI 0.776 to 0.924), The Hosmer-Lemeshow goodness-of-fit was 5.780 (p = 0.328). At a cutoff value of 3.5, the sensitivity and specificity were 75% and 83%, respectively. CONCLUSION: Several disease-specific factors of breast cancer (e.g., menopause, endocrine therapy, and upper extremity lymphedema) play important roles in the development of PICC-RVT. Patients at higher PICC-RVT risk could be candidates for close post-insertion monitoring and interventions to prevent PICC-RVT.
PURPOSE: Limited risk assessment tool to stratify the risk of PICC-related thrombosis (PICC-RVT) in breast cancer patients. This study developed a model to assess the risk of PICC-RVT in breast cancer patients. METHODS: We conducted a retrospective cohort study of 1284 breast cancer patients receiving PICC insertion from January 1, 2015, to August 31, 2019, at a cancer specialized hospital in Hunan province, China. The entire population was divided into two groups at a ratio of 3:1 which included a derivation sample (n = 978), and a validation sample (n = 284). PICC-RVT was confirmed by ultrasonography in the presence of clinical symptoms and signs. RESULTS: PICC-RVT occurred in 40 (4.09%) of the derivation sample patients. Multivariable analysis identified 9 variables: chronic obstructive pulmonary disease, prior central venous catheter placement, higher level of platelets, higher level of D-dimer, lower level of activated partial thromboplastin time, menopause, no prior breast surgery, upper extremity lymphedema, and endocrine therapy. Points were assigned to each variable according to regression coefficient. The model had an area under the receiver operating characteristics curve (AUC) of 0.850 (95% CI 0.776 to 0.924), The Hosmer-Lemeshow goodness-of-fit was 5.780 (p = 0.328). At a cutoff value of 3.5, the sensitivity and specificity were 75% and 83%, respectively. CONCLUSION: Several disease-specific factors of breast cancer (e.g., menopause, endocrine therapy, and upper extremity lymphedema) play important roles in the development of PICC-RVT. Patients at higher PICC-RVT risk could be candidates for close post-insertion monitoring and interventions to prevent PICC-RVT.
Authors: Sandrine Lavau-Denes; P Lacroix; A Maubon; P M Preux; D Genet; L Vénat-Bouvet; J L Labourey; J Martin; P Slaouti; N Tubiana-Mathieu Journal: Cancer Chemother Pharmacol Date: 2013-05-01 Impact factor: 3.333
Authors: V Chopra; S Kaatz; A Conlon; D Paje; P J Grant; M A M Rogers; S J Bernstein; S Saint; S A Flanders Journal: J Thromb Haemost Date: 2017-09-13 Impact factor: 5.824