627 - Risk Factors for Chest Port-related Skin Complications in Oncologic Population

Purpose: Although uncommon, chest ports can complicate the skin over the port reservoir such as skin erosion or wound dehiscence (port-related skin complications). The purpose of this study was to identify risk factors for port-related skin complications in oncologic population.

Materials and Methods: Among 4,704 ports placed in 4,524 patients between 2013 and 2024, 4,245 (Male/Female: 2058/2187, median age: 63 years old) were placed for treatment of cancer. Skin complications including erosion, would dehiscence and others (erythema, rash, and bleeding/hematoma) were recorded through chart review. Port site infection and delayed wound healing related to bevacizumab were not considered as skin complications. Patient characteristics (age, gender, BMI, diabetes, steroid/anticoagulant/ antiplatelet agent use, leukopenia /neutropenia/ thrombocytopenia/ hypoalbuminemia at the time of port placement, clinical history) and port characteristics (right vs. left, lumen number, catheter tip location, and prior port removal) were recorded. Multivariate proportional subdistribution hazards regression (PSHREG) was used to identify risk factors for skin complications.

Results: The cumulative follow-up period of all patients was 2,207,538 catheter-days (median: 342 catheter-days, range: 1-3,956 catheter-days). A total of 118/4245 patients (2.8%) developed port-related skin complications (0.053 events/1000 catheter days) resulting in port removal in 90/118 (76.3%). The median time to skin complications was 138 days (range: 4-3,381 catheter-days). The skin complications were comprised of 70 erosions, 25 wound dehiscence, and 23 others (16 erythema, 4 rash, and 3 bleeding/hematoma). Port site skin complications led to removal in 90 cases (90/118, 76.3%) which included: 66/70 erosions, 16/25 wound dehiscence, 8/23 others (5/15 erythema, 2/4 rash, 1/3 bleeding). Univariate PSHREG analysis indicated that underweight BMI (BMI< 18.5) (P < 0.01), leukopenia (P = 0.04), neutropenia (P = 0.01), central nervous system (CNS) cancer (P < 0.01), and lung cancer (P < 0.01) to be the significant risk factors. Multivariate analysis further confirmed that underweight BMI (hazard ratio (HR): 2.53, 95% confidence interval (CI): 1.32-4.85, P < 0.01), CNS cancer (HR: 8.39, 95% CI: 3.56-19.80, P < 0.01), and lung cancer (HR: 1.75, 95% CI: 1.16-2.63, P < 0.01) were independent risk factors for skin complications.

Conclusion: Underweight BMI (< 18.5), CNS cancer, and lung cancer are independent risk factors for chest port skin complications.