Prophylactic gastrostomy improves outcomes in head and neck cancer

Prophylactic percutaneous endoscopic gastrostomy (pPEG) can enhance nutrition outcomes, reduce treatment delay, and maintain quality of life (QoL) in patients with head and neck cancer (HNC), suggests a recent study.

A team of investigators enrolled 335 patients with HNC (296 males) between 1 April 2013 and 17 April 2019 and extracted data on patient characteristics and treatment modalities from medical records. They compared the different enteral feeding methods through univariate and multivariate analyses and assessed overall survival (OS) outcomes by the log-rank test using the Kaplan‒Meier method.

Of the participants, 46 underwent pPEG tube, 23 reactive PEG, and 266 reactive nasogastric tube insertion, with a median follow-up time of 29.5 months.

Multivariate analysis revealed that pPEG, increased body mass index (BMI), and N0-1 category significantly correlated with less weight loss (p<0.05 for all). In addition, pPEG reduced the rate of radiotherapy delay relative to that of reactive interventions (23.1 percent vs 47.1 percent; p=0.007).

Among patients who underwent pPEG tube insertion, the following factors significantly correlated with improved QoL: global health status, role functioning, emotional functioning, cognitive functioning, pain, and dyspnoea (p<0.05 for all).

BMI and weight loss were independently associated with clinical survival outcomes (p<0.05 for all).

These findings showed that pPEG could improve nutrition outcomes, reduce treatment delay, and maintain QoL among patients with HNC, according to the investigators.