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Comparison of peripherally inserted central venous catheters (PICC) versus subcutaneously implanted port-chamber catheters by complication and cost for patients receiving chemotherapy for non-haematological malignancies

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Abstract

Purpose

Indwelling central venous catheters (CVCs) have been increasingly used to enable delivery of intravenous chemotherapy. We aimed to compare the safety and cost of two commonly used CVCs, peripherally inserted central venous catheter (PICCs) and ports, in the delivery of chemotherapy in patients with non-haematological malignancies.

Methods

Seventy patients were randomly assigned to receive either a PICC or a port. The primary endpoint was occurrence of major complications, which required removal of the CVC and secondary endpoints included occurrence of any complications.

Results

Port devices were associated with fewer complications compared with PICC lines (hazard ratio of 0.25, CI, 0.09–0.86, P = 0.038). Major complication rate was lower in the port arm compared to the PICC arm (0.047 versus 0.193 major complications/100 catheter days, P = 0.034) with 6 versus 20 % of patients experiencing major complications, respectively. Thrombosis, the most common complication, was significantly higher in the PICC arm compared to the port arm (25 versus 0 %, P = 0.013). Quality of life and cost estimates did not differ significantly between the two arms.

Conclusions

Port devices are associated with a lower risk of complications, with no difference in cost, compared to PICC lines in patients with non-haematological malignancies receiving intravenous chemotherapy.

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Acknowledgments

We would like to acknowledge the Adelaide Cancer Trials and Education Cooperative (ACTEC) for collaboration with this study.

Conflict of interest

The authors have no conflicts of interest to declare. The authors have full control of all primary data and agree to allow the journal to review the data if requested.

Author information

Authors and Affiliations

  1. Department of Medical Oncology, Flinders Centre for Innovation in Cancer, Flinders Medical Centre/Flinders University, Bedford Park, SA, 5042, Australia

    G. S. Patel, K. Jain, R. Kumar, M. Ly, B. Koczwara, G. Kichenadasse & C. S. Karapetis

  2. Department of Medical Oncology, Monash Cancer Centre, East Bentleigh, VIC, 3165, Australia

    A. H. Strickland & L. Pellegrini

  3. Flinders Centre for Epidemiology and Biostatistics, School of Medicine, Faculty of Health Sciences, Flinders University, Bedford Park, SA, 5042, Australia

    J. Slavotinek & S. Ullah

  4. South Australia Medical Imaging, South Australia Department of Health, Adelaide, Australia

    J. Slavotinek

  5. Breast and Endocrine Unit, Flinders Medical Centre, Bedford Park, SA, 5042, Australia

    M. Eaton & W. McLeay

  6. Department of Medical Oncology, The Queen Elizabeth Hospital, Woodville South, SA, 5011, Australia

    T. Price

  7. School of Medicine, Adelaide University, Adelaide, SA, 5005, Australia

    T. Price

Authors
  1. G. S. Patel
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  2. K. Jain
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  3. R. Kumar
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  4. A. H. Strickland
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  5. L. Pellegrini
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  6. J. Slavotinek
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  7. M. Eaton
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  8. W. McLeay
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  9. T. Price
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  10. M. Ly
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  11. S. Ullah
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  12. B. Koczwara
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  13. G. Kichenadasse
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  14. C. S. Karapetis
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Corresponding author

Correspondence to G. S. Patel.

Electronic supplementary material

Below is the link to the electronic supplementary material.

S1

CONSORT diagram depicting patient enrolment (DOCX 39 kb)

S2

Time to insertion/Dwell time Bar charts demonstrating the median time to CVC insertion (A) and the median CVC dwell time (B). Error bars represent the interquartile range. P values <0.01 according to the Mann–Whitney U test for non-parametric data. (DOCX 35 kb)

S3

Effect of indwelling CVC upon quality of life measures as per a study-specific scale for CVCs. Bar chart summarising median score from quality of life questionnaires designed specifically for patients with indwelling CVCs (No validated questionnaires for measurement of quality of life for CVCs are in use). Error bars represent the interquartile range. (DOCX 43 kb)

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Patel, G.S., Jain, K., Kumar, R. et al. Comparison of peripherally inserted central venous catheters (PICC) versus subcutaneously implanted port-chamber catheters by complication and cost for patients receiving chemotherapy for non-haematological malignancies. Support Care Cancer 22, 121–128 (2014). https://doi.org/10.1007/s00520-013-1941-1

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  • DOI: https://doi.org/10.1007/s00520-013-1941-1

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