Comparison of three types of central venous catheters in patients with malignant tumor receiving chemotherapy

Background Central venous catheters (CVCs) have been an effective access for chemotherapy instead of peripherally intravenous catheters. There were limited studies on the choices and effects of different types of CVCs for chemotherapy. The aim of this study was to compare the complications, cost, and patients’ quality of life and satisfaction of three commonly used CVCs for chemotherapy, such as implanted venous port, peripherally inserted central catheters (PICCs), and external non-tunneled central venous catheters (NTCs). Methods A double-center prospective cohort study was carried out from March 2014 to December 2016. Catheterization situation, complications, catheter maintenance, cost, and patients’ quality of life and satisfaction were recorded, investigated, and analyzed. Forty-five ports, 60 PICCs and 40 NTCs were included. All the CVCs were followed up to catheter removal. Results There was no statistical difference in catheterization success rates between port and PICC. NTC had less success rate by one puncture compared with port. Ports had fewer complications compared with PICCs and NTCs. The complication rates of ports, PICCs and NTCs were 2.2%, 40%, and 27.5%, respectively. If the chemotherapy process was <12 months, NTCs cost least, and the cost of port was much higher than PICC and NTC. When the duration time was longer than 12 months, the cost of port had no difference with the cost of PICC. Quality of life and patients’ satisfaction of port group were significantly higher than the other two groups. Conclusion Although port catheterization costs more and needs professional medical staff and strict operational conditions, ports have fewer complications and higher quality of life and patients’ satisfaction than PICCs and NTCs. Therefore, not following consideration of the economic factor, we recommend port as a safe and an effective chemotherapy access for cancer patients, especially for whom needing long chemotherapy process.

[1]  Yuan Tian,et al.  Risk associated with central catheters for malignant tumor patients: a systematic review and meta-analysis , 2015, Oncotarget.

[2]  G. Bhat,et al.  Outcomes, cost comparison, and patient satisfaction during long-term central venous access in cancer patients: Experience from a Tertiary Care Cancer Institute in South India , 2016, Indian Journal of Medical and Paediatric Oncology.

[3]  L. Kang,et al.  Application and comparison of different implanted ports in malignant tumor patients , 2016, World Journal of Surgical Oncology.

[4]  Steve Hill.  Trapezius placement of implanted ports: understanding the procedure. , 2016, British journal of nursing.

[5]  P. Lähteenmäki,et al.  Complications associated with central venous access device in children with haemophilia: a nationwide multicentre study in Finland , 2015, Haemophilia : the official journal of the World Federation of Hemophilia.

[6]  M. Sonobe,et al.  A retrospective analysis on the utility and complications of upper arm ports in 433 cases at a single institute , 2015, International Journal of Clinical Oncology.

[7]  Steve Hill.  Totally implanted ports: the trapezius approach in practice. , 2015, British journal of nursing.

[8]  C. Marchetti,et al.  A retrospective analysis of trabectedin infusion by peripherally inserted central venous catheters: a multicentric Italian experience , 2015, Anti-cancer drugs.

[9]  T. Çil,et al.  Performance of venous port catheter insertion by a general surgeon: a prospective study. , 2015, International surgery.

[10]  Yuxiu Liu,et al.  Peripherally inserted central catheter thrombosis incidence and risk factors in cancer patients: a double-center prospective investigation , 2015, Therapeutics and clinical risk management.

[11]  D. Sidloff,et al.  A comparison of Infections and Complications in Central Venous Catheters in Adults with Solid Tumours , 2015, The journal of vascular access.

[12]  Wen Hu,et al.  A randomised, controlled trial comparing the long-term effects of peripherally inserted central catheter placement in chemotherapy patients using B-mode ultrasound with modified Seldinger technique versus blind puncture. , 2014, European journal of oncology nursing : the official journal of European Oncology Nursing Society.

[13]  M. Wilcox,et al.  epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England , 2007, Journal of Hospital Infection.

[14]  V. Chopra,et al.  The Risk of Bloodstream Infection Associated with Peripherally Inserted Central Catheters Compared with Central Venous Catheters in Adults: A Systematic Review and Meta-Analysis , 2013, Infection Control &#x0026; Hospital Epidemiology.

[15]  A. Palmo,et al.  Catheter-related complications in cancer patients on home parenteral nutrition: a prospective study of over 51,000 catheter days. , 2013, JPEN. Journal of parenteral and enteral nutrition.

[16]  B. Koczwara,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 , 2013, Supportive Care in Cancer.

[17]  D. Mukherji,et al.  Update on totally implantable venous access devices. , 2012, Surgical oncology.

[18]  Shu-Fen Lu,et al.  [Prevention and nursing care of central line-associated bloodstream infections in critically ill patients]. , 2012, Hu li za zhi The journal of nursing.

[19]  A. Clements,et al.  Catheter-associated bloodstream infection incidence and risk factors in adults with cancer: a prospective cohort study. , 2011, The Journal of hospital infection.

[20]  Sanjay Saint,et al.  Guidelines for the prevention of intravascular catheter-related infections. , 2011, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[21]  D. Radice,et al.  Best choice of central venous insertion site for the prevention of catheter-related complications in adult patients who need cancer therapy: a randomized trial. , 2009, Annals of oncology : official journal of the European Society for Medical Oncology.

[22]  J. Seymour,et al.  Infective and thrombotic complications of central venous catheters in patients with hematological malignancy: prospective evaluation of nontunneled devices , 2009, Supportive Care in Cancer.

[23]  S. Loibl,et al.  Management of venous port systems in oncology: a review of current evidence. , 2008, Annals of oncology : official journal of the European Society for Medical Oncology.

[24]  J. Kuhn,et al.  A prospective randomized trial demonstrating valved implantable ports have fewer complications and lower overall cost than nonvalved implantable ports. , 2004, American journal of surgery.

[25]  H. Liebman,et al.  Thromboembolic complications of cancer: Epidemiology, pathogenesis, diagnosis, and treatment , 2003, American journal of hematology.

[26]  D. Armstrong,et al.  Infectious Morbidity Associated with Long-Term Use of Venous Access Devices in Patients with Cancer , 1993, Annals of Internal Medicine.

[27]  T. Stijnen,et al.  Complications from long‐term indwelling central venous catheters in hematologic patients with special reference to infection , 1989, Cancer.