Abstract
BackgroundMany patients with cancer or other systemic illnesses can experience malnutrition. One way to mitigate malnutrition is by insertion of a percutaneous endoscopic gastrostomy feeding tube (PEG tube). The goal of this retrospective matched cohort study is to evaluate if PEG tube placement improved nutritional status and overall survival (OS) in advanced gastroesophageal (GE) cancer patients who are undergoing anti-neoplastic therapy.MethodsGE cancer patients who were treated and evaluated by a nutritionist and had at least 2 nutritionist follow-up visits were identified. Patients with PEG tube were matched to patients that did not undergo PEG placement (non-PEG). Clinical characteristics, GE symptoms reported at nutrition follow-up visits, and OS were recorded.Results20 PEG and 18 non-PEG cases met criteria for further analyses. After correction for multiple testing, there were no OS differences between PEG and non-PEG, treatment naive and previously treated. However, PEG esophageal carcinoma has statistically significant inferior OS compared with non-PEG esophageal carcinoma. PEG placement did not significantly reduce the proportion of patients with weight loss between the initial nutrition assessment and 12-week follow-up.ConclusionsIn this small study, PEG placement had inferior OS outcome for GE esophageal carcinoma, no improvement in OS for other evaluated groups, and did not reduce weight loss between baseline and 12-week follow-up. Unless there is prospective randomized trial that can show superiority of PEG placement in this population, PEG placement in this group cannot be endorsed.
Highlights
Gastroesophageal (GE) cancers are known to commonly produce a variety of GE-related symptoms, such as dysphagia and cachexia that can lead to malnutrition [1]
PEG esophageal carcinoma has statistically significant inferior overall survival (OS) compared with not undergo PEG placement (non-PEG) esophageal carcinoma
While previous studies have shown a a positive correlation between nutritional stasis and overall quality of life (QoL), the relationship between PEG tube use, nutrition status, and treatment outcomes in patients who are undergoing anti-neoplastic therapies has not been thoroughly examined [7,8,9,10]. The goal of this retrospective matched cohort study is to evaluate if PEG tube placement improved nutritional status and overall survival (OS) in advanced GE cancer patients who are undergoing anti-neoplastic therapy
Summary
Gastroesophageal (GE) cancers are known to commonly produce a variety of GE-related symptoms, such as dysphagia and cachexia that can lead to malnutrition [1]. Controlling malnutrition is a major concern in the treatment of patients undergoing anti-neoplastic therapy. Malnutrition is one of the main contributors towards a decline in a patient’s nutritional status and their overall quality of life (QoL) [4]. Mitigating and alleviating malnutrition is a major concern in the management of cancer patients receiving anti-neoplastic therapies. One way to mitigate malnutrition is by insertion of a percutaneous endoscopic gastrostomy feeding tube (PEG tube). The goal of this retrospective matched cohort study is to evaluate if PEG tube placement improved nutritional status and overall survival (OS) in advanced gastroesophageal (GE) cancer patients who are undergoing anti-neoplastic therapy
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