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Scientific Oral Presentations

Head and Neck Surgery

Session: Scientific Oral Presentations 4 - Head and Neck Surgery

Comparison of Prophylactic vs Reactive Percutaneous Endoscopic Gastrostomy Tubes in Head and Neck Cancer Patients

Sunday, September 29, 2024
1:54 PM – 2:00 PM EDT
Location: MBCC, 208
Disclosure(s):
Emily C. Wood, MS, RD, LDN:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Alyssa C. Weinfurther, MS, RD, CSO, LDN:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Fendi Obuekwe, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Mikayla Renee Bisignani, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Jonas T. Johnson, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Head and neck cancer (HNC) patients commonly undergo Percutaneous Endoscopic Gastrostomy (PEG) tube placement as a means of receiving supplemental nutrition during radiation. There is varied data on the impact on weight loss and predictors of timing of PEG tube placement. This study investigates the weight loss difference between reactive and prophylactic PEG tubes, while also evaluating the predictors associated with prophylactic tube placement.

Methods: A retrospective study was conducted, evaluating HNC patients treated with radiation therapy at an academic-affiliated cancer center from 2015 to 2020. Cancer and treatment characteristics were obtained from the head/neck organ-specific database. The history of pre-treatment dysphagia, pre-treatment BMI, and weight at the onset and termination of treatment were abstracted from the medical record. A linear mixed-effects model was used to investigate the impact of PEG tube strategy on weight loss, while logistic regression assessed predictors influencing PEG tube choice.

Results: The study encompassed 153 patients with a mean age of 60.87 (SD 10.80) and mean BMI of 26.13 (SD 5.88). The most prevalent tumor site and stage was oropharyngeal (49%) and TIV (32.7%). Fifty-one patients received a prophylactic PEG and 102 received a reactively placed PEG. Patients with a prophylactic PEG tube showed significantly less weight loss (5.74 kg) than those receiving a reactive PEG tube. (95% CI 3.75, 7.73, p< 0.0001). Lower BMI (OR=0.89, 95% CI 0.82, 0.96, p=0.006), use of platinum-based chemotherapy (OR=0.37, 95% CI 0.14, 0.95, p=0.046), and incidence of surgical intervention (OR=4.27, 95%CI 1.85, 10.55, p= 0.002) were associated with prophylactic PEG placement.

Conclusions: Prophylactic PEG tubes were associated with significantly less weight loss when compared to those placed reactively. Patient and treatment factors were identified as predictors of prophylactic PEG placement. Future research could explore the impact of prophylactic PEG tubes on unplanned hospital admissions and treatment interruptions.

    Presenting Author(s)

  • Emily C. Wood, MS, RD, LDN

    Dietitian
    UPMC
    Sharon, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • JL

    Jinhong Li, MS

    Graduate Student Researcher
    University of Pittsburgh, School of Public Health, Department of Biostatistics
    Pittsburgh, Pennsylvania, United States

    Disclosure information not submitted.

  • Alyssa C. Weinfurther, MS, RD, CSO, LDN

    Dietitian
    UPMC Hillman Cancer Center
    Pittsburgh, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Fendi Obuekwe, BS

    Medical Student
    University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center Department of Otolaryngology
    Pittsburgh, Pennsylvania, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Mikayla Renee Bisignani, BS

    Medical Student
    University of Pittsburgh School of Medicine
    Pittsburgh, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Jonas T. Johnson, MD

    EmeritProfessor, Department of Otolaryngology; Professor, Department of Radiation Oncology Professor
    Department of Otolaryngology – Head and Neck Surgery, University of Pittsburgh, Medical Center
    Pittsburgh, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • Marci L. Nilsen, PhD

    Assistant Professor
    University of Pittsburgh, School of Nursing, Department of Acute and Tertiary Care
    Pittsburgh, Pennsylvania, United States

    Disclosure information not submitted.