Central venous catheters for infusion therapy in gastrointestinal cancer. A comparative study of tunnelled centrally placed catheters and peripherally inserted central catheters.

Protracted venous infusion of 5-fluorouracil (5-FU) is a common treatment for patients with gastrointestinal malignancy. A central venous access device is required for safe and effective drug delivery. This study uses a survival analysis to compare the useful life and treatment completion success of tunelled centrally placed catheters (TCPCs) and peripherally inserted central catheters (PICCs). It also describes complications found with both devices. Data on insertion, complications, and removal of TCPCs and PICCs were collected on standardized forms, prospectively for initial PICCs and retrospectively for initial TCPCs. Survival of indwelling catheters was similar for both devices for the first 120 days, but after that TCPC survival was statistically better than that of PICCs (P = 0.051). Complications occurred in 61% of patients with TCPCs and 67% of patients with PICCs. The authors conclude that PICCs provide less invasive, more cost-effective, and easier to schedule central venous access for 5-FU infusion; however, their advantage over TCPCs decreases significantly in treatments lasting more than 120 days.