Gastrostomy tubes in patients with advanced head and neck cancer

Khwaja Asif Ahmed*, Sandeep Samant, Francisco Vieira

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

29 Scopus citations

Abstract

Objectives: To measure the percentage of patients requiring gastrostomy tubes (G-tubes) and the timing of their placement, in addition to studying whether pretreatment variables (T stage, tumor site, N stage) and intratreatment variables (weight loss during treatment) are valid predictors for the need for G-tube placement. Study Design: Retrospective case control study. Methods: Retrospective review of a prospectively collected database with chart reviews was carried out on 477 patients treated on a regimen of intraarterial cisplatin and concurrent radiation. The likelihood of requiring a G-tube was calculated by studying several independent variables using chi-square analysis and the unpaired t test. Results: Two hundred twenty (46%) patients had G-tubes placed, with mean time of placement being on day 20 after the initiation of treatment. Patients with T4 disease were statistically more likely to require a G-tube (50% vs. 37%, P < .05). Patients were less likely to require a G-tube when the primary site of tumor involved the larynx or paranasal sinuses (P < .05). There were no statistically significant differences between the two groups with regards to patient age, sex, N stage, and weight changes over the course of treatment. The odds of requiring a G-tube were highest for tumors involving the hypopharynx (80%), oral cavity (52%), and oropharynx (49%). Conclusions: Although clinical judgment appears to be sufficient for deciding when G-tube placement is warranted in our population, the threshold for placing a tube should be lower in those patients who had a higher likelihood of requiring a G-tube during the course of treatment, including those with advanced disease of the oral cavity, oropharynx, and hypopharynx.

Original languageEnglish (US)
Pages (from-to)44-47
Number of pages4
JournalLaryngoscope
Volume115
Issue number1 I
DOIs
StatePublished - Jan 1 2005

Keywords

  • Chemoradiation
  • Gastrostomy
  • Head and neck cancer

ASJC Scopus subject areas

  • Otorhinolaryngology

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