Timing of administration of bevacizumab chemotherapy affects wound healing after chest wall port placement

BACKGROUND: The authors investigated how the timing of administration of bevacizumab, a targeted vascular endothelial growth factor-inhibiting chemotherapeutic agent, affected the risk of wound healing in patients undergoing chest wall port placement. METHODS: The authors performed a retrospective search was performed of an institutional review board approved, Health Insurance Portability and Accountability Act compliant database between 2002 and 2008, identifying 1108 port placements in patients who were treated with bevacizumab. One hundred twenty of these ports eventually required explant. Data analyzed included patient demographics, indication for port removal, and schedule of bevacizumab therapy. RESULTS: Wound healing complications requiring port explant were seen in 0.9% of placements (10/1108). When bevacizumab was given within 1 day of port placement, the absolute risk (AR) of port removal for wound dehiscence was 2.4% (2/82), compared with 0.3% (3/1021) when 2 or more days had passed between port placement and bevacizumab administration, yielding a statistically significant relative risk (RR) of 8.1 (P < .02). Similarly, when bevacizumab was administered within 7 days of port insertion, there was a significant RR of dehiscence-related port explant (AR 1.4% vs 0.1%, RR 11.5, P < .028). However, no significant RR for dehiscence-related port removal was observed when bevacizumab was administered within 14 days (AR 0.9% vs 0.2%, RR 6.2, P < .09) or 30 days (AR 0.7% vs 0.2%, RR 3.7, P < .23) of port placement. CONCLUSIONS: The risk of a wound dehiscence requiring chest wall port explant in patients treated with bevacizumab was inversely proportional to the interval between bevacizumab administration and port placement, with significantly higher risk seen when the interval is less than 14 days.