Effect of prophylactic gastrostomy on nutritional and clinical outcomes in patients with head and neck cancer.

Publisher: Nature Publishing Group Country of Publication: England NLM ID: 8804070 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-5640 (Electronic) Linking ISSN: 09543007 NLM ISO Abbreviation: Eur J Clin Nutr Subsets: MEDLINE

Publication: <2003->: London : Nature Publishing Group
Original Publication: London : J. Libbey, c1988-

Gastrostomy*/adverse effects ; Head and Neck Neoplasms*/therapy; Male ; Female ; Humans ; Quality of Life ; Intubation, Gastrointestinal ; Weight Loss ; Retrospective Studies

Background: We aimed to identify which enteral feeding method was most beneficial for patients and compare clinical outcomes, quality of life, and complication rates by assessing patients who underwent prophylactic percutaneous endoscopic gastrostomy (pPEG) tube, reactive percutaneous endoscopic gastrostomy (rPEG) tube or reactive nasogastric tube (rNGT) insertion.
Methods: Patients with head and neck cancers (HNCs) were enrolled between April 1, 2013 and April 17, 2019 (n = 335; 296 males, 39 females). Data concerning patient characteristics and treatment modalities were extracted from the medical records. Comparisons between enteral feeding methods were made by univariate and multivariate analysis. Overall survival (OS) outcomes were analyzed by the log rank test using the Kaplan-Meier method.
Results: A total of 335 patients were included. The median follow-up time was 29.5 months. There were forty-six patients in the pPEG tube group, 23 patients in the rPEG tube group, and 266 patients in the rNGT group. pPEG, increased body-mass index (BMI), and N0-1 category were significantly associated with less weight loss in the multivariate analysis (all P < 0.05). pPEG decreased the rate of radiotherapy delay compared with that of reactive interventions (23.1% vs. 47.1%, P = 0.007). In terms of quality of life, global health status, role functioning, emotional functioning, cognitive functioning, pain, and dyspnea were significantly improved in the pPEG tube group (all P < 0.05). BMI and weight loss were independent prognostic factors for clinical survival outcomes (all P < 0.05).
Conclusions: pPEG could improve nutrition outcomes, reduce treatment delay, and maintain quality of life.
(© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)

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Date Created: 20220509 Date Completed: 20221104 Latest Revision: 20221109

20240829

10.1038/s41430-022-01154-x

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