Complications and risk factors for removal of totally implanted venous access ports in patients receiving systemic anticancer treatment

INTRODUCTION: Totally implantable venous access ports (TIVAPs) are widely used in oncology for administering systemic anticancer treatment, but they may be associated with infectious, mechanical, thrombotic, and local complications. This study aimed to evaluate the incidence and spectrum of TIVAP-related complications and iden­tify factors associated with port removal in hospitalized oncology patients. MATERIAL AND METHODS: This single-center retrospective study included 393 patients who underwent TIVAP implan­tation between February 2024 and November 2025. Data were obtained from electronic medical records. Patient-, treatment-, and device-related variables were analyzed. The primary outcome was the occurrence of port-related complications, with time to removal assessed using multivariable Cox proportional hazards regression. RESULTS: A total of 393 patients were analyzed, with a median follow-up of 161 days (IQR: 74–251). Port-related complications occurred in 42 patients (10.7%), with infectious complications being the most common (20/42). Port removal due to complications was required in 31 patients (7.9%). In multivariable time-to-event analysis, administration of systemic anticancer treatment prior to port implantation was associated with higher hazard of port removal due to complications (HR = 2.16; 95% CI 1.04–4.49; p = 0.039). No other clinical factors showed a significant association. CONCLUSIONS: TIVAP-related complications occurred in approximately 10.7% of patients, with infectious complica­tions being the most frequent. This underscores the importance of vigilant monitoring and standardized infection prevention practice in patients with implanted venous ports. Prior administration of systemic anticancer treatment before port implantation was associated with a higher hazard of port removal, suggesting that the timing of port insertion relative to systemic therapy may influence device durability. These findings warrant validation in further prospective studies.