Peripherally inserted central catheters in non-hospitalized cancer patients: 5-year results of a prospective study

Support Care Cancer. 2015 Feb;23(2):403-9. doi: 10.1007/s00520-014-2387-9. Epub 2014 Aug 14.


Purpose: Few prospective follow-up studies evaluating the use of peripherally inserted central catheters (PICCs) to deliver chemotherapy and/or home parenteral nutrition (HPN) have focused exclusively on oncology outpatients. The aim of this prospective study was to assess the reliability and the safety of PICCs over a 5-year use in non-hospitalized cancer patients requiring long-term intravenous therapies.

Methods: Since June 2008, all adult oncology outpatient candidates for PICC insertion were consecutively enrolled and the incidence of catheter-related complications was investigated. The follow-up continued until the PICC removal.

Results: Two hundred sixty-nine PICCs in 250 patients (98 % with solid malignancies) were studied, for a total of 55,293 catheter days (median dwell time 184 days, range 15-1,384). All patients received HPN and 71 % received chemotherapy during the study period. The incidence of catheter-related bloodstream infections (CRBSIs) was low (0.05 per 1,000 catheter days), PICC-related symptomatic thrombosis was rare (1.1 %; 0.05 per 1,000 catheter days), and mechanical complications were uncommon (13.1 %; 0.63 per 1,000 catheter days). The overall complication rate was 17.5 % (0.85 per 1,000 catheter days) and PICCs were removed because of complications only in 7 % of cases. The main findings of this study were that, if accurately managed, PICCs can be safely used in cancer patients receiving chemotherapy and/or HPN, recording a low incidence of CRBSI, thrombosis, and mechanical complications; a long catheter life span; and a low probability of catheter removal because of complications.

Conclusions: Our study suggests that PICCs can be successfully utilized as safe and long-lasting venous access devices in non-hospitalized cancer patients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Catheter-Related Infections* / epidemiology
  • Catheter-Related Infections* / etiology
  • Catheterization, Peripheral* / adverse effects
  • Catheterization, Peripheral* / methods
  • Catheterization, Peripheral* / statistics & numerical data
  • Central Venous Catheters / adverse effects*
  • Drug Therapy / methods
  • Female
  • Follow-Up Studies
  • Home Care Services, Hospital-Based / statistics & numerical data
  • Humans
  • Incidence
  • Italy
  • Male
  • Middle Aged
  • Neoplasms* / drug therapy
  • Parenteral Nutrition, Home* / methods
  • Parenteral Nutrition, Home* / statistics & numerical data
  • Prospective Studies
  • Reproducibility of Results
  • Thrombosis* / epidemiology
  • Thrombosis* / etiology