Image Guided Therapy, Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G1X8, Canada.
Department of Medical Imaging, University of Toronto, Toronto, Canada.
Pediatr Blood Cancer. 2022 Sep;69(9):e29832. doi: 10.1002/pbc.29832. Epub 2022 Jul 7.
In children with cancer, port-a-caths (ports) are commonly placed in the right anterior chest wall, leaving a visible scar when removed. The psychological impact of port scars on survivors is unknown. It is unclear whether alternative sites should be considered. We assessed the impact of port scars on pediatric cancer survivors to determine whether a change in location is indicated.
We performed a cross-sectional single-center study of pediatric cancer survivors aged 13-18 years. A questionnaire explored participants' perceptions of their port scars. Four additional validated tools were used: Fitzpatrick scale, Patient and Observer Scar Assessment Scale (POSAS), Children's Dermatology Life Quality Index, and a Distress Thermometer.
Among 100 participants (median age 15.8 years [13-18], median duration since treatment 8 years [1.5-14.8]), 75 'never/occasionally' thought about their port scars, 85 were not bothered by its location and 87 would not have preferred another site. Eleven participants were highly impacted by their scars: six thought about their scar 'everyday/all the time', four were highly bothered by its location, and nine would have preferred a different location. There was an association between the desire for different scar location and how much the location bothered participants (p < 0.0001), female sex (p = 0.03) and Patient POSAS score (p = 0.04).
A port scar on the anterior chest wall was not a major concern for the majority of this cohort. A minority of participants were highly impacted by the scar and its location. Advance identification of those likely to be impacted by their scars may not be possible.
在患有癌症的儿童中，通常会在右前胸壁放置端口（导管），移除时会留下可见的疤痕。端口疤痕对幸存者的心理影响尚不清楚。尚不清楚是否应考虑替代部位。我们评估了端口疤痕对儿科癌症幸存者的影响，以确定是否需要更改位置。
我们对 13-18 岁的儿科癌症幸存者进行了横断面单中心研究。一份问卷探讨了参与者对其端口疤痕的看法。还使用了另外四个经过验证的工具：Fitzpatrick 量表，患者和观察者疤痕评估量表（POSAS），儿童皮肤病生活质量指数和痛苦温度计。
在 100 名参与者中（中位年龄为 15.8 岁[13-18]，中位治疗后时间为 8 年[1.5-14.8]），75 名“从未/偶尔”想到过他们的端口疤痕，85 名对其位置不感到困扰，87 名不会选择其他位置。有 11 名参与者受到疤痕的严重影响：6 名参与者“每天/一直”想到他们的疤痕，4 名参与者对其位置感到困扰，9 名参与者希望有不同的位置。希望有不同的疤痕位置与疤痕位置对参与者的困扰程度之间存在关联（p<0.0001），女性（p=0.03）和患者 POSAS 评分（p=0.04）。
对于大多数队列来说，前胸壁上的端口疤痕不是主要关注点。少数参与者受到疤痕及其位置的严重影响。可能无法提前确定那些可能会受到疤痕影响的人。
