Comparative safety of PICC-ports and chest ports in oncology: A monocentric retrospective cohort study.

INTRODUCTION: Peripherally inserted central catheter ports (PICC-ports) are a recent alternative to traditional chest ports for long-term vascular access in oncology. While associated with easier insertion and improved patient comfort, comparative safety data remain limited. Prior meta-analyses were not conclusive as they included patients from older cohorts in whom outdated brachial or arm ports were used. This warrants further studies evaluating the safety profile of PICC-ports in a general cancer population. MATERIALS AND METHODS: We conducted a retrospective, single-center study comparing safety of PICC-ports and chest ports in adult oncology patients implanted between August 2022 and November 2024. Patients with contraindications to PICC-ports or receiving continuous infusion chemotherapy were excluded to minimize indication bias. All catheters were placed by a trained vascular access team using the ultrasound-guided micro-Seldinger technique and standardized protocols (SIP-Port and ISALT3). The primary outcome was the rate of severe adverse events (SAE) per 1000 catheter-days (CD), defined as complications requiring device removal, hospitalization, or resulting in death. Secondary outcomes included transient adverse events (TAE). RESULTS: A total of 329 patients were included (172 chest ports, 157 PICC-ports). Baseline characteristics were broadly comparable between groups. SAE incidence was comparable between groups (0.47 vs 0.55 per 1000 CD, p = 0.672). Similarly, TAE rates showed no significant difference (1.05 vs 0.79 per 1000 CD, p = 0.331). However, PICC-ports had more frequent placement failures, while chest ports had significantly more catheter occlusions requiring urokinase (p < 0.01). CONCLUSION: In this retrospective cohort, PICC-ports demonstrated a safety profile comparable to chest ports, with fewer occlusions but more placement failures. These results support the routine clinical use of PICC-ports in eligible patients, though further randomized trials are needed to confirm long-term outcomes.