Abstract
BackgroundCurrent studies about percutaneous endoscopic gastrostomy (PEG) tube placement report equivalent patient outcomes with prophylactic PEG tubes (pPEGs) versus common nutritional support. Unreported was if omitting a pPEG is associated with an increased risk of complications leading to a treatment-related unplanned hospitalization (TRUH).MethodsTRUHs were retrospectively analyzed in patients with advanced head and neck squamous cell carcinoma (n = 310) undergoing (chemo)radiotherapy with (pPEG) or without PEG (nPEG).ResultsIn 88 patients (28%), TRUH was reported. One of the leading causes of TRUH in nPEG patients was inadequate oral intake (n = 16, 13%), and in pPEG patients, complications after PEG tube insertion (n = 12, 10%). Risk factors for TRUH were poor performance status, tobacco use, and surgical procedures.ConclusionsOmitting pPEG tube placement without increasing the risk of an unplanned hospitalization due to dysphagia, dehydration or malnutrition, is an option in patients being carefully monitored. Patients aged > 60 years with hypopharyngeal carcinoma, tobacco consumption, and poor performance status appear at risk of PEG tube-related complications leading to an unplanned hospitalization.
Highlights
Current studies about percutaneous endoscopic gastrostomy (PEG) tube placement report equivalent patient outcomes with prophylactic PEG tubes versus common nutritional support
Patients In this retrospective single-center chart review, we identified a database of 310 consecutive Union for International Cancer Control (UICC) stage III–IVB head and neck squamous cell carcinoma (HNSCC) patients treated between 2007 and 2012 with primary or adjuvant chemo-RT with a curative intent
We investigated possible risk factors for a PEG-associated event in a subgroup analysis, which revealed that tumor localization to hypopharynx (P = 0.0183), active tobacco consumption (P = 0.0009), tobacco use > 40 pack-years (P = 0.0001), poor ECOG Eastern Cooperative Oncology Group performance status (PS) (2/3) (P = 0.0418), and age > 60 years (P = 0.0352) were risk factors in the univariate analysis
Summary
Current studies about percutaneous endoscopic gastrostomy (PEG) tube placement report equivalent patient outcomes with prophylactic PEG tubes (pPEGs) versus common nutritional support. Retrospective analyses examining the indication for PEG tube placement showed differing results, again making a conclusive statement challenging [7] This is further complicated by the fact that a prophylactically inserted PEG (pPEG) is sometimes found subsequently not to be needed [8]. The study compared the use of pPEGs with common nutritional support and enteral tube feeding (when considered necessary) inserted after the start of treatment reactively (rPEG). It resulted in no difference in swallowing function, tube dependence, and the prevalence of clinically relevant esophageal strictures. Our study aimed to analyze if omitting a PEG tube in LAHNSCC patients was associated with an increased risk of complications leading to an unplanned hospitalization (UH), compared to patients receiving a PEG tube prophylactically
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
