International experts consensus on optimal central vascular access device selection and management for patients with cancer

Background: In patients with cancer, the choice of an appropriate venous access device is crucial for effective treatment, minimizing complications, and reducing healthcare costs. Key management decisions, such as the timing of device removal post-therapy, can impact clinical outcomes. As current international guidelines lack specific directives for these issues, a global consensus of experts, representing different countries, was deemed appropriate. Methods: A panel of 11 experts from three continents, including oncologists and healthcare professionals, was chosen. After a comprehensive review of clinical trials and guidelines on central venous access devices (CVAD) in oncology published between January 2013 and December 2023, the panel developed and voted on specific recommendations for the selection and management of CVADs in patients with cancer, during a 2-day meeting. Results: The panel reached consensus on 10 issues concerning (a) indications for a CVAD, (b) available options for CVADs, (c) role of the staff and patients in the choice of CVAD, (d) factors influencing the selection of a port over an external catheter, (e) logistical requirements for port and external catheter insertion, (f) stakeholders responsible for port and external catheter insertion, (g) factors determining the removal of a port after completing the definitive therapy, and (h) recommended frequency of flushing when the CVAD is not in use. Conclusions: The results of the consensus may offer healthcare professionals a global view of some critical issues concerning CVADs for cancer therapy, helping to establish recommendations for local clinical practice.