Post-Treatment Trajectories of Retained Totally Implantable Venous Access Ports After Anticancer Therapy: A Conditional Landmark Cohort Study

Figures

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  Figure 1. Cohort construction and nested analytic datasets. Of 1548 source records, 134 did not meet electronic eligibility criteria, and 1414 underwent pre-landmark assessment. Eight patients experienced a first event before day 90 (six elective removals and two deaths), leaving 1406 patients in the primary day-90 conditional-landmark cohort. The removal-procedure dataset was record-based and is not equivalent to patient-level first-event counts. The reactivation and structured-assessment datasets were nested subcohorts derived from the primary cohort. Dashed connectors denote nested analytic datasets rather than sequential exclusions. TIVAP, totally implantable venous access port.

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  Figure 2. Cumulative incidence of post-treatment outcomes among patients with retained totally implantable venous access ports (TIVAPs) after intravenous anticancer therapy. (a) Elective TIVAP removal after the day-90 conditional landmark. (b) Competing first events, including TIVAP reactivation, complication-related removal, and death recorded within institutional follow-up systems. Curves were estimated using the Aalen–Johansen method; shaded areas represent 95% confidence intervals, dashed segments indicate follow-up beyond 18 months, and the risk table presents patients remaining event-free and under observation.

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  Figure 3. Exploratory burden assessment, management preferences, and patient–clinician concordance after treatment completion. (a) Exploratory TIVAP-related burden domains among the event-free assessed subcohort (n = 1319). Bars show pooled proportions of moderate or marked responses across direct patient and proxy assessments using locally developed, unvalidated subjective burden items; respondent-stratified results are provided in Supplementary Figure S1. (b) Current documented TIVAP-management preferences recorded near the assessment date. Categories were mutually exclusive and included continued retention, earlier removal, uncertain preference, no explicit preference, and unrecorded preference. (c) Treatment-phase acceptability and documentation completeness. Responses indicating willingness to choose a TIVAP again for similar future treatment and willingness to recommend TIVAP use reflect retrospective treatment-phase acceptability rather than current management preference. (d) Patient–clinician management concordance among paired directional records (n = 322). Values in the matrix represent the number of assessments classified according to patient preference and clinician…