Candidemia in cancer patients: Impact of early removal of non-tunneled central venous catheters on outcome

Liu, C.Y.; Huang, L.J.; Wang, W.S.; Chen, T.L.; Yen, C.C.; Yang, M.H.; Hsiao, L.T.; Liu, C.Y.; Chen, P.M.; Chiou, T.J.

doi:10.1016/j.jinf.2008.12.008

Cited by 67Antifungal resistance and susceptibilityCentral Venous Catheters and HemodialysisNeutropenia and Cancer Infections

Candidemia in cancer patients: Impact of early removal of non-tunneled central venous catheters on outcome

Liu, C.Y., Huang, L.J., Wang, W.S., Chen, T.L., Yen, C.C., Yang, M.H., Hsiao, L.T., Liu, C.Y. +2 more·2009·Journal of Infection

DOI 10.1016/j.jinf.2008.12.008

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Abstract

Objective To explore the impact of retention of non-tunneled central venous catheters (CVCs) on survival in candidemic cancer patients, where CVCs are commonly used and essential. A second object was to determine whether early CVC removal would benefit a subset of cancer patients.Methods We retrospectively evaluated 92 cancer patients who had a single, non-tunneled CVC in place. Patients were grouped according to CVC retention or removal; the later group was subdivided into early (CVC removed <or=72h after candidemia onset) and late removal. A Cox regression model was used for determining risk factors of adverse outcome and Kaplan-Meier analyses for comparing in-hospital 3-30 day survival among subgroups.Results Baseline characteristics were comparable between CVC retention (n=20) or removal (n=72) groups. CVC retention was a significant risk factor of poor outcome, independent of other significant prognostic host factors (hazard ratio 7.15, 95% confidence interval 3.51-14.53, p<0.001). Patients of early CVC removal (n=40) had significant better survival than those of late removal (n=32) (p<0.001).Conclusion The results suggest that retention of CVCs has a negative impact on survival in candidemic cancer patients, and that early CVC removal should be considered in a subset of cancer patients with candidemia.

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Despite contradictory data from a post-hoc analysis of 2 clinical trials, it is generally accepted that indwelling CVCs should be removed as early as possible in all patients with candidemia.
“Despite contradictory data from a post-hoc analysis of 2 clinical trials [98], it is generally accepted that indwelling CVCs should be removed as early as possible in all patients with candidemia [11,12,84,96].”
From Treatment of Invasive Candidiasis: A Narrative Review (2018) · cites this paper as [96]

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Authors: Liu, C. Y., Huang, L. J., Wang, W. S., Chen, T. L., Yen, C. C., Yang, M. H., Hsiao, L. T., Liu, C. Y., Chen, P. M., & Chiou, T. J.
Affiliations: Taipei Veterans General Hospital (TW)
National Yang Ming University Hospital (TW)
Corresponding author: Chiou, T.J.
ORCID: Yang, M.H.
Venue: Journal of Infection
Publisher: Elsevier BV
Published: 2009-02
Volume: 58
Issue: 2
Pages: 154-160
ISSN: 0163-4453 (ISSN-L)
DOI: 10.1016/j.jinf.2008.12.008
OpenAlex: W2032385343
Cited by: 67
References: 39
Citations by year: 2026: 1 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 4 · 2021: 2 · 2020: 4 · 2019: 4 · 2018: 2 · 2017: 2 · 2016: 7 · 2015: 8 · 2014: 4 · 2013: 4 · 2012: 9
FWCI: 4.12
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Journal of Infection (publishedVersion)
PubMed (publishedVersion)
Funders: Taipei Veterans General Hospital
Topics: Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Health Sciences › Health Professions › Emergency Medical Services › Central Venous Catheters and Hemodialysis
Health Sciences › Medicine › Oncology › Neutropenia and Cancer Infections
Keywords: candidemia, catheter removal timing, catheter retention, cancer patients, survival, prognostic factors, fungemia
MeSH terms: Aged, Aged, 80 and over, Candida, Candidiasis, Catheterization, Central Venous, Female, Humans, Male, Neoplasms, Retrospective Studies, Risk Factors, Time Factors, Survival Analysis, Fungemia, Treatment Outcome

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Candidemia in cancer patients: Impact of early removal of non-tunneled central venous catheters on outcome

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