Document Detail

Central Venous Line Dysfunction is an Independent Predictor of Poor Survival in Children With Cancer.
MedLine Citation:
PMID:  22278202     Owner:  NLM     Status:  Publisher    
Central venous line (CVL) dysfunction (mainly from thrombotic occlusion) is a frequent, but relatively less-studied complication compared with infection and thromboembolism (TE). In adults with cancer, TE results in poor outcome. We evaluated the impact of CVL-dysfunction and TE on overall survival (OS) and event-free survival (EFS) in children with noncentral nervous system cancer (n=358). CVL-dysfunction was defined as persistent or recurrent difficulty of blood draw and/or infusion. Event was defined as cancer relapse, second malignancy, or death due to any cause. OS and EFS were estimated using Kaplan-Meier method and survival curves compared using log-rank test. Hazard ratios (HR) were calculated using the Weibull regression model. Diagnosis of TE (n=43, 12%) had no effect on the OS and EFS. Children with CVL-dysfunction (n=74, 21%) had shorter 5- and 10-year EFS compared with children without CVL-dysfunction (P=0.029 and P=0.027). Multiple regression analyses, adjusting for age, sex, diagnostic era, TE, and cancer type identified CVL-dysfunction as an independent determinant of 5-year OS (HR 1.87; 95% confidence interval, 1.02-3.42; P=0.043) and EFS (HR 1.96; 95% confidence interval, 1.23-3.41; P=0.018). Although the etiology of adverse impact of CVL-dysfunction on survival is unknown, its prevention and prompt treatment may improve outcome from cancer in children. Further prospective studies are recommended.
Uma H Athale; Sabrina Siciliano; Ji Cheng; Lehana Thabane; Anthony K C Chan
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-23
Journal Detail:
Title:  Journal of pediatric hematology/oncology     Volume:  -     ISSN:  1536-3678     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9505928     Medline TA:  J Pediatr Hematol Oncol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
*Department of Pediatrics, Division of Hematology/Oncology, McMaster University †Hematology/Oncology Service, McMaster Children's Hospital, Hamilton Health Sciences Corporation ‡Department of Epidemiology and Biostatistics, McMaster University §Biostatistics Unit, Father Sean O'Sullivan Research Centre ∥Centre for Evaluation of Medicines, St Joseph's Healthcare, Hamilton, Hamilton, ON, Canada.
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