| アブストラクト | BACKGROUND: Vascular access guidelines in Western countries recommend the central venous (CV) administration of cytotoxic chemotherapy agents to reduce complications such as extravasation. However, in Japan, peripheral venous administration is common. This study aimed to clarify the current status of using CV ports in Japan and its associated patient and institutional factors in breast cancer cases. METHODS: This retrospective cohort study used the Diagnosis Procedure Combination data documented between 2013 and 2022 from 238 hospitals. Participants were patients with breast cancer who underwent mastectomy and perioperative chemotherapy. Data on patient demographics, anticancer drugs used, and hospital characteristics were collected from the inpatient and outpatient episodes. Factors associated with CV port implantation were examined using logistic regression analysis. RESULTS: Among 45,960 patients, 113 (0.25%) underwent CV port implantation, mostly postoperatively and at trunk sites. Factors negatively associated with CV port use included partial mastectomy (Odds ratio, 0.62 [95% confidence interval,0.41-0.92]) (vs. total mastectomy), use of only irritant drugs (0.43[0.21-0.90]) (vs. vesicants), and treatment at medium-volume hospitals (0.34 [0.16-0.73]) (vs. low-volume hospitals), whereas use of both vesicant and irritant drugs or nonvesicant drugs, and high volume hospital did not show statistical significance. CONCLUSION: CV ports were used in only 0.25% of breast cancer surgery cases, suggesting highly selective utilization. Their implantation may be influenced not only by clinical factors but also by institutional characteristics and practice patterns, highlighting the need for the context-specific use of CV ports. |
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| 投稿者 | Abe, Mari; Morita, Kojiro; Konishi, Takaaki; Nara, Katsuhiko; Kimura, Yuya; Fushimi, Kiyohide; Yasunaga, Hideo; Nakagami, Gojiro |
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| 組織名 | Department of Gerontological Nursing/Wound Care Management, Graduate School of;Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.;Research Institute of Next-Generation Nursing Education, Bunkyo-ku, Tokyo, Japan.;Department of Nursing, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan.;UTokyo Nursing Dissemination and Implementation Science Institute, Bunkyo-ku,;Tokyo, Japan.;Department of Nursing Administration, Graduate School of Medicine, The University;of Tokyo, Bunkyo-ku, Tokyo, Japan.;Department of Breast and Endocrine Surgery, Graduate School of Medicine, The;University of Tokyo, Bunkyo-Ku, Tokyo, Japan.;Institute for Cancer Control, Division of Health Services Research, National;Cancer Center, Chuo-ku, Tokyo, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.;Department of Pharmacy, The University of Tokyo Hospital, Bunkyo-ku, Tokyo,;Japan.;Department of Health Services Research, Graduate School of Medicine, The;University of Tokyo, Tokyo, Japan.;Department of Health Policy and Informatics Institute of Science Tokyo Graduate;School of Medical and Dental Sciences, Bunkyo-ku, Tokyo, Japan.;gojiron@g.ecc.u-tokyo.ac.jp.;Division of Care Innovation, Global Nursing Research Center, Bunkyo-ku, Tokyo,;Japan. gojiron@g.ecc.u-tokyo.ac.jp. |
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