title: Incidence, risk factors and treatment outcomes of extravasation of cytotoxic agents in an outpatient chemotherapy clinic.
abstract: OBJECTIVE
  Extravasation, the accidental leakage of an anticancer agent from a vessel into the surrounding tissues, can lead to irreversible local injuries and severe disability. Despite its considerable clinical importance, evidence-based information on extravasation in chemotherapy is lacking. This study characterized the clinical features of extravasation and identified issues to be resolved in current cancer chemotherapy performed in outpatient settings.
  
  
  METHODS
  We retrospectively reviewed the medical charts of patients who received chemotherapy and sustained extravasation in our Outpatient Chemotherapy Clinic from April 2007 to August 2012. Chemotherapy administration and extravasation management procedures were standardized using the in-house chemotherapy guideline.
  
  
  RESULTS
  Among 43 557 patients who received chemotherapy, 35 (0.08%) experienced extravasation. The duration between the start of infusion and extravasation was >2 h in 28 (80.0%) patients. The severity of extravasation was Grades 1, 2 and 3 in 28, 2 and 5 patients, respectively-three of whom were associated with port trouble. The contributing factor for extravasation was walking in 11 (31.4%) patients. All extravasations were cured without surgical intervention by management according to our guidelines.
  
  
  CONCLUSIONS
  The incidence of extravasation is as low as 0.08%, using our in-house chemotherapy guideline. Extravasation from implanted ports tends to be severe.
authors.affiliation: *Department of Medical Oncology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba 260-8670, Japan. isekine@chiba-u.jp.
authors.forename: Emiko
authors.initials: E
authors.lastname: Sakaida
authors.forename: Ikuo
authors.initials: I
authors.lastname: Sekine
authors.forename: Shunichiro
authors.initials: S
authors.lastname: Iwasawa
authors.forename: Ryota
authors.initials: R
authors.lastname: Kurimoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Uehara
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Ooka
authors.forename: Naoki
authors.initials: N
authors.lastname: Akanuma
authors.forename: Yuji
authors.initials: Y
authors.lastname: Tada
authors.forename: Chiaki
authors.initials: C
authors.lastname: Imai
authors.forename: Tomoko
authors.initials: T
authors.lastname: Oku
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Takiguchi
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D002173:Cancer Care Facilities / Q000706:statistics & numerical data*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010348:Patient Care Team; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
keywords: chemotherapy; cytotoxic agents; extravasation; outpatient