Successful use of indwelling tunneled catheters for the management of effusions in children with advanced cancer

Background Malignant pleural effusion (MPE) and ascites (MA) negatively impact quality of life of palliative patients. Treatment options are limited. This study's purpose is to examine the experience with indwelling tunneled catheters (ITCs) for management of MPE/MA in children with advanced ca...

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Published in	Pediatric blood & cancer Vol. 61; no. 6; pp. 1007 - 1012
Main Authors	den Hollander, Barbara S., Connolly, Bairbre L., Sung, Lillian, Rapoport, Adam, Zwaan, C.M., Grant, Ronald M., Parra, Dimitri, Temple, Michael J.
Format	Journal Article
Language	English
Published	United States Blackwell Publishing Ltd 01.06.2014 Wiley Subscription Services, Inc
Subjects	Adolescent ascites Ascites - etiology Ascites - surgery Ascites - therapy Catheter-Related Infections - etiology catheters Catheters, Indwelling - adverse effects Child Child, Preschool Drainage - instrumentation Drainage - methods Female Hematology Home Care Services Humans indwelling Male malignant Oncology Pain - etiology Palliative Care Paracentesis Patient Acceptance of Health Care pediatric oncology Pediatrics pleural effusion Pleural Effusion, Malignant - etiology Pleural Effusion, Malignant - surgery Pleural Effusion, Malignant - therapy Pleurodesis Quality of Life Recurrence Retrospective Studies Sarcoma - complications ascites pediatric oncology catheters pleural effusion indwelling malignant
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Abstract	Background Malignant pleural effusion (MPE) and ascites (MA) negatively impact quality of life of palliative patients. Treatment options are limited. This study's purpose is to examine the experience with indwelling tunneled catheters (ITCs) for management of MPE/MA in children with advanced cancer. Methods Children with MPE/MA who underwent ITC insertion (2007–2012) were retrospectively reviewed. Clinical, procedural, complication and outcome details were analyzed. Results PleurX® ITCs (n = 12) were inserted in eight patients (5–18 years) with sarcoma (11 MPE, 1 MA), achieving symptom relief and facilitating discharge home post ITC (median 2 days). Median survival following ITC was 51 days. There were two major complications: pain (n = 1), late site infection (n = 1), and five minor complications. Drainage ceased in four patients (pleurodesis/tumor progression). At time of death, six ITCs (five patients) were still in situ. Conclusions ITC appears to be a safe, effective treatment for MPE/MA in advanced pediatric cancer, achieving symptomatic relief and discharge home. Pediatr Blood Cancer 2014;61:1007–1012. © 2013 Wiley Periodicals, Inc.
AbstractList	Background Malignant pleural effusion (MPE) and ascites (MA) negatively impact quality of life of palliative patients. Treatment options are limited. This study's purpose is to examine the experience with indwelling tunneled catheters (ITCs) for management of MPE/MA in children with advanced cancer. Methods Children with MPE/MA who underwent ITC insertion (2007–2012) were retrospectively reviewed. Clinical, procedural, complication and outcome details were analyzed. Results PleurX® ITCs (n = 12) were inserted in eight patients (5–18 years) with sarcoma (11 MPE, 1 MA), achieving symptom relief and facilitating discharge home post ITC (median 2 days). Median survival following ITC was 51 days. There were two major complications: pain (n = 1), late site infection (n = 1), and five minor complications. Drainage ceased in four patients (pleurodesis/tumor progression). At time of death, six ITCs (five patients) were still in situ. Conclusions ITC appears to be a safe, effective treatment for MPE/MA in advanced pediatric cancer, achieving symptomatic relief and discharge home. Pediatr Blood Cancer 2014;61:1007–1012. © 2013 Wiley Periodicals, Inc. Malignant pleural effusion (MPE) and ascites (MA) negatively impact quality of life of palliative patients. Treatment options are limited. This study's purpose is to examine the experience with indwelling tunneled catheters (ITCs) for management of MPE/MA in children with advanced cancer. Children with MPE/MA who underwent ITC insertion (2007-2012) were retrospectively reviewed. Clinical, procedural, complication and outcome details were analyzed. PleurX® ITCs (n = 12) were inserted in eight patients (5-18 years) with sarcoma (11 MPE, 1 MA), achieving symptom relief and facilitating discharge home post ITC (median 2 days). Median survival following ITC was 51 days. There were two major complications: pain (n = 1), late site infection (n = 1), and five minor complications. Drainage ceased in four patients (pleurodesis/tumor progression). At time of death, six ITCs (five patients) were still in situ. ITC appears to be a safe, effective treatment for MPE/MA in advanced pediatric cancer, achieving symptomatic relief and discharge home. BACKGROUNDMalignant pleural effusion (MPE) and ascites (MA) negatively impact quality of life of palliative patients. Treatment options are limited. This study's purpose is to examine the experience with indwelling tunneled catheters (ITCs) for management of MPE/MA in children with advanced cancer.METHODSChildren with MPE/MA who underwent ITC insertion (2007-2012) were retrospectively reviewed. Clinical, procedural, complication and outcome details were analyzed.RESULTSPleurX® ITCs (n = 12) were inserted in eight patients (5-18 years) with sarcoma (11 MPE, 1 MA), achieving symptom relief and facilitating discharge home post ITC (median 2 days). Median survival following ITC was 51 days. There were two major complications: pain (n = 1), late site infection (n = 1), and five minor complications. Drainage ceased in four patients (pleurodesis/tumor progression). At time of death, six ITCs (five patients) were still in situ.CONCLUSIONSITC appears to be a safe, effective treatment for MPE/MA in advanced pediatric cancer, achieving symptomatic relief and discharge home. Background Malignant pleural effusion (MPE) and ascites (MA) negatively impact quality of life of palliative patients. Treatment options are limited. This study's purpose is to examine the experience with indwelling tunneled catheters (ITCs) for management of MPE/MA in children with advanced cancer. Methods Children with MPE/MA who underwent ITC insertion (2007-2012) were retrospectively reviewed. Clinical, procedural, complication and outcome details were analyzed. Results PleurX ITCs (n=12) were inserted in eight patients (5-18 years) with sarcoma (11 MPE, 1 MA), achieving symptom relief and facilitating discharge home post ITC (median 2 days). Median survival following ITC was 51 days. There were two major complications: pain (n=1), late site infection (n=1), and five minor complications. Drainage ceased in four patients (pleurodesis/tumor progression). At time of death, six ITCs (five patients) were still in situ. Conclusions ITC appears to be a safe, effective treatment for MPE/MA in advanced pediatric cancer, achieving symptomatic relief and discharge home. Pediatr Blood Cancer 2014;61:1007-1012. © 2013 Wiley Periodicals, Inc. [PUBLICATION ABSTRACT]
Author	Grant, Ronald M. Temple, Michael J. Sung, Lillian Connolly, Bairbre L. Parra, Dimitri Rapoport, Adam Zwaan, C.M. den Hollander, Barbara S.
Author_xml	– sequence: 1 givenname: Barbara S. surname: den Hollander fullname: den Hollander, Barbara S. organization: Division of Haematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada – sequence: 2 givenname: Bairbre L. surname: Connolly fullname: Connolly, Bairbre L. email: Correspondence to: Bairbre L. Connolly, Image Guided Therapy, Diagnostic Imaging, Sick Kids Hospital, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8., bairbre.connolly@sickkids.ca organization: Department of Diagnostic Imaging, Image Guided Therapy, The Hospital for Sick Children, University of Toronto, Ontario, Toronto, Canada – sequence: 3 givenname: Lillian surname: Sung fullname: Sung, Lillian organization: Division of Haematology/Oncology, The Hospital for Sick Children, University of Toronto, Ontario, Toronto, Canada – sequence: 4 givenname: Adam surname: Rapoport fullname: Rapoport, Adam organization: Paediatric Advanced Care Team, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada – sequence: 5 givenname: C.M. surname: Zwaan fullname: Zwaan, C.M. organization: Department of Pediatric Oncology/Haematology, Erasmus MC-Sophia Children's Hospital, University of Rotterdam, The Netherlands, Rotterdam – sequence: 6 givenname: Ronald M. surname: Grant fullname: Grant, Ronald M. organization: Division of Haematology/Oncology, The Hospital for Sick Children, University of Toronto, Ontario, Toronto, Canada – sequence: 7 givenname: Dimitri surname: Parra fullname: Parra, Dimitri organization: Department of Diagnostic Imaging, Image Guided Therapy, The Hospital for Sick Children, University of Toronto, Ontario, Toronto, Canada – sequence: 8 givenname: Michael J. surname: Temple fullname: Temple, Michael J. organization: Department of Diagnostic Imaging, Image Guided Therapy, The Hospital for Sick Children, University of Toronto, Ontario, Toronto, Canada
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Cites_doi	10.1055/s-2008-1039109 10.1503/cmaj.110392 10.1016/j.lungcan.2005.05.016 10.1089/jpm.2010.0539 10.1007/s10147-011-0312-5 10.1097/MCP.0b013e32832c6a8a 10.1378/chest.06-2353 10.1007/s00247-006-0392-y 10.1245/s10434-009-0691-2 10.1089/jpm.2009.0061 10.3322/caac.20073 10.1378/chest.129.2.362 10.1097/JTO.0b013e31820d614f 10.1016/j.athoracsur.2007.11.039 10.1097/01.RVI.0000094601.83406.e1 10.1007/S12325-010-0031-8 10.1183/09031936.01.00225601 10.1016/j.arbres.2009.09.009 10.1136/thx.2010.136994 10.1177/1479972311407216
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Snippet	Background Malignant pleural effusion (MPE) and ascites (MA) negatively impact quality of life of palliative patients. Treatment options are limited. This... Malignant pleural effusion (MPE) and ascites (MA) negatively impact quality of life of palliative patients. Treatment options are limited. This study's purpose... Background Malignant pleural effusion (MPE) and ascites (MA) negatively impact quality of life of palliative patients. Treatment options are limited. This... BACKGROUNDMalignant pleural effusion (MPE) and ascites (MA) negatively impact quality of life of palliative patients. Treatment options are limited. This...
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SubjectTerms	Adolescent ascites Ascites - etiology Ascites - surgery Ascites - therapy Catheter-Related Infections - etiology catheters Catheters, Indwelling - adverse effects Child Child, Preschool Drainage - instrumentation Drainage - methods Female Hematology Home Care Services Humans indwelling Male malignant Oncology Pain - etiology Palliative Care Paracentesis Patient Acceptance of Health Care pediatric oncology Pediatrics pleural effusion Pleural Effusion, Malignant - etiology Pleural Effusion, Malignant - surgery Pleural Effusion, Malignant - therapy Pleurodesis Quality of Life Recurrence Retrospective Studies Sarcoma - complications
Title	Successful use of indwelling tunneled catheters for the management of effusions in children with advanced cancer
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