PICC line or port catheter: Which one for cancer patients?

It can be challenging knowing when to insert a peripherally inserted central catheter (PICC) or port catheter into patients with cancer. The choice of central venous catheter (CVC) is critical in oncology. As an oncology professional, you have multiple factors to consider. Different options involve different benefits and potential complications.

What are the advantages of PICCs?

Oncological drugs and central venous access were developed after the end of World War II. The port catheter was invented around 1970. PICC lines have been available since the 1970s, but their use has increased significantly since 2000 for several reasons1:

  • Ease of placement
  • Ultrasound guidance ensures proper position
  • Lower cost of insertion compared to other CVCs
  • Lower risk of bleeding
  • Ease of removal

What are the potential risks associated with CVCs?

  1. What is the risk of BSIs between different CVCs?

Chopra et al performed a systematic review comparing complication rates between PICCs and other CVCs2. According to the results, PICCs placed in inpatients were twice as likely to cause bloodstream infections (BSIs) than those placed in outpatients2.


  1. Falzone L, Salomone S, Libra M. Evolution of Cancer Pharmacological Treatments at the Turn of the Third Millennium. Front Pharmacol. 2018;9:1300. doi: 10.3389/fphar.2018.01300 
  2. Li G, Zhang Y, Ma H, Zheng J. Arm port vs chest port: a systematic review and meta-analysis. Cancer Manag Res. 2019 Jul 3;11:6099-6112. doi: 10.2147/CMAR.S205988 
  3. Cotogni P, Barbero C, Garrino C, et al. Peripherally inserted central catheters in non-hospitalized cancer patients: 5-year results of a prospective study. Support Care Cancer. 2014;23(2):403-409. 
  4. Mielke D, Wittig A, Teichgräber U. Peripherally inserted central venous catheter (PICC) in outpatient and inpatient oncological treatment. Support Care Cancer. 2020;28(10):4753-4760. doi: 10.1007/s00520-019-05276-0 
  5. Chopra V, Anand S, Krein SL, Chenoweth C, Saint S. Bloodstream infection, venous thrombosis, and peripherally inserted central catheters: reappraising the evidence. Am J Med. 2012;125(8):733-741. 
  6. Saber W, Moua T, Williams EC, et al. Risk factors for catheter-related thrombosis (CRT) in cancer patients: a patient-level data (IPD) meta-analysis of clinical trials and prospective studies. J Thromb Haemost. 2011;9(2):312-319. 
  7. Yeow M, Soh S, Yap R, Tay D, Low YF, Goh SSN, Yeo CS, Lo ZJ. A systematic review and network meta-analysis of randomized controlled trials on choice of central venous access device for delivery of chemotherapy. J Vasc Surg Venous Lymphat Disord. 2022:S2213-333X(22)00171-8. doi: 10.1016/j.jvsv.2022.03.007 
  8. Campagna S, Gonella S, Berchialla P, et al. Can Peripherally Inserted Central Catheters Be Safely Placed in Patients with Cancer Receiving Chemotherapy? A Retrospective Study of Almost 400,000 Catheter-Days. Oncologist. 2019;24(9):e953-e959. 
  9. Campagna S, Gonella S, Zerla PA, et al. The Risk of Adverse Events Related to Extended-Dwell Peripheral Intravenous Access. Infect Control Hosp Epidemiol. 2018;39(7):875-877.