ArticleFrontiers in oncology2026
Supra-pectoralis major implantation of totally implantable venous access ports in emaciated oncology patients: a single-center retrospective study.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Emaciated oncology patients present unique challenges for totally implantable venous access port (TIVAP) implantation because of limited subcutaneous tissue coverage over the anterior chest wall. Conventional subcutaneous port placement in this population may increase the risk of local complications, including skin erosion, port exposure, and pocket infection. This study aimed to evaluate the feasibility, safety, and short-term clinical outcomes of supra-pectoralis major TIVAP implantation in emaciated oncology patients. Methods: This retrospective single-center study included 188 consecutive emaciated oncology patients who underwent TIVAP implantation using the supra-pectoralis major technique at the Changshu Hospital Affiliated to Nanjing University of Chinese Medicine between January 2023 and June 2024. Emaciation was defined as a body mass index (BMI) <18.5 kg/m² and subcutaneous fat thickness ≤5 mm at the intended implantation site. All procedures were performed under ultrasound guidance, and catheter tip position was confirmed by fluoroscopy. Technical success, operative time, postoperative complications, and functional port retention during 6-12 months of follow-up were evaluated. Results: A total of 188 patients were included. The mean age was 70.2 ± 7.8 years, and the mean BMI was 16.3 ± 1.1 kg/m². Technical success was achieved in all patients (100%) with a mean operative time of 24.8 ± 5.8 minutes. During follow-up, device-related complications occurred in 11 patients (5.85%), including port exposure in 2 (1.06%), pocket infection in 4 (2.13%), catheter malposition in 3 (1.60%), and fibrin sheath formation in 2 (1.06%). Four patients (2.13%) required port removal because of complications, while the remaining 184 patients (97.87%) retained a functional port until the end of follow-up or until death from underlying malignancy. During the observation period, 82 patients (43.62%) died from progression of the primary disease. Conclusion: In this single-center retrospective series, supra-pectoralis major implantation of TIVAPs was technically feasible in emaciated oncology patients and was associated with a high technical success rate and an acceptable short-term complication profile. These preliminary observations suggest that the technique may represent a practical implantation option in this vulnerable population.
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