Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-23T06:55:54.921Z Has data issue: false hasContentIssue false
  • English
  • Français

Factors affecting duration of gastrostomy tube retention in survivors following treatment for head and neck cancer

Published online by Cambridge University Press:  11 March 2014

H Blanchford ,
D Hamilton ,
I Bowe ,
S Welch ,
R Kumar ,
J W Moor ,
A R Welch  and
V Paleri
H Blanchford
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK
D Hamilton
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK
I Bowe
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK
S Welch
Affiliation:
Department of Anaesthesia, North Tyneside General Hospital, North Shields, UK
R Kumar
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK
J W Moor
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Sunderland Royal Hospital, Sunderland, UK
A R Welch
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK
V Paleri*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK
*
Address for correspondence: Mr V Paleri, Department of Otolaryngology, Head and Neck Surgery, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Many patients treated for head and neck cancer require nutritional support, which is often delivered using a gastrostomy tube. It is difficult to predict which patients will retain their gastrostomy tube in the long term. This study aimed to identify the factors which affect the duration of gastrostomy tube retention.

Method:

In this retrospective study, 151 consecutive patients from one centre were audited. All patients had a mucosal tumour of the head and neck, and underwent gastrostomy tube insertion between 2003 and 2007.

Results:

There were near-complete data sets for 132 patients. The gastrostomy tube was retained in survivors (n = 66) for a mean of 21.3 months and in non-survivors (n = 66) for 11.9 months. Univariate analysis showed that co-morbidity was the only factor which significantly increased duration of gastrostomy tube retention in survivors (p = 0.041).

Conclusion:

Co-morbidity alone was associated with a significant increase in gastrostomy tube retention. It is suggested that co-morbidity be included as a variable in future relevant research. Co-morbidity should also be considered when counselling patients about their long-term function following cancer treatment. Gastrostomy tube retention is likely to be affected by many factors, with few single variables having importance independently.

Keywords

Head And Neck CancerGastrostomyComorbidityNutritional Support
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 3 , March 2014 , pp. 263 - 267
Copyright
Copyright © JLO (1984) Limited 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Grant, DG, Bradley, PT, Pothier, DD, Bailey, D, Caldera, S, Baldwin, DL et al. Complications following gastrostomy tube insertion in patients with head and neck cancer: a prospective multi-institution study, systematic review and meta-analysis. Clin Otolaryngol 2009;34:103–12Google Scholar
2Wollman, B, D'Agostino, HB, Walus-Wigle, JR, Easter, DW, Beale, A. Radiologic, endoscopic, and surgical gastrostomy: an institutional evaluation and meta-analysis of the literature. Radiology 1995;197:699–704Google Scholar
3Paleri, V, Patterson, J. Use of gastrostomy in head and neck cancer: a systematic review to identify areas for future research. Clin Otolaryngol 2010;35:177–89Google Scholar
4Nugent, B, Parker, MJ, McIntyre, IA. Nasogastric tube feeding and percutaneous endoscopic gastrostomy tube feeding in patients with head and neck cancer. J Hum Nutr Diet 2010;23:277–84Google Scholar
5Brown, T, Spurgin, A, Crombie, J, Ross, L, Tripcony, L, Keller, J et al. Improved sensitivity of swallowing and nutrition guidelines to predict which head and neck cancer patients will benefit from prophylactic gastrostomy placement. Asia Pac J Clin Oncol 2010;6(suppl 3):114Google Scholar
6Zuercher, BF, Grosjean, P, Monnier, P. Percutaneous endoscopic gastrostomy in head and neck cancer patients: indications, techniques, complications and results. Eur Arch Otorhinolaryngol 2011;268:623–9Google Scholar
7Moor, JW, Patterson, J, Kelly, C, Paleri, V. Prophylactic gastrostomy before chemoradiation in advanced head and neck cancer: a multiprofessional web-based survey to identify current practice and to analyse decision making. Clin Oncol (R Coll Radiol) 2010;22:192–8Google Scholar
8Owen, S, Patterson, J, Johnson, K, Paleri, V. Factors associated with long-term retention of gastrostomy in head and neck cancer patients. In: Abstracts of the 13th British Academic Conference in Otolaryngology and ENT Expo, July 8–10, 2009, Liverpool, UK. Clin Otolaryngol 2009;34(suppl 1):69–70Google Scholar
9Sobin, LH, Wittekind, C, eds. TNM Classification of Malignant Tumours, 6th edn.Hoboken, New Jersey: John Wiley & Sons, 2002Google Scholar
102001 Townsend scores. In: http://census.ukdataservice.ac.uk/get-data/related/deprivation.aspx [6 February 2014]Google Scholar
11Townsend, P, Phillimore, P, Beattie, A. Health and Deprivation: Inequality and the North. London: Routledge, 1988Google Scholar
12Piccirillo, J, Costas, I, Claybour, P, Borah, A, Grove, L, Jeffe, D. The measurement of comorbidity by cancer registries. J Registry Manag 2003;30:8–14Google Scholar
13Schweinfurth, JM, Boger, GN, Feustel, PJ. Preoperative risk assessment for gastrostomy tube placement in head and neck cancer patients. Head Neck 2001;23:376–82CrossRefGoogle ScholarPubMed
14Cheng, SS, Terrell, JE, Bradford, CR, Ronis, DL, Fowler, KE, Prince, ME et al. Variables associated with feeding tube placement in head and neck cancer. Arch Otolaryngol Head Neck Surg 2006;132:655–61Google Scholar
15Li, B, Li, D, Lau, DH, Farwell, DG, Luu, Q, Rocke, DM et al. Clinical-dosimetric analysis of measures of dysphagia including gastrostomy-tube dependence among head and neck cancer patients treated definitively by intensity-modulated radiotherapy with concurrent chemotherapy. Radiat Oncol 2009;4:52Google Scholar
16Chapuy, CI, Annino, DJ, Snavely, A, Li, Y, Tishler, RB, Norris, CM et al. Swallowing function following postchemoradiotherapy neck dissection: review of findings and analysis of contributing factors. Otolaryngol Head Neck Surg 2011;145:428–34Google Scholar
17Chen, AM, Li, BQ, Lau, DH, Farwell, DG, Luu, Q, Stuart, K et al. Evaluating the role of prophylactic gastrostomy tube placement prior to definitive chemoradiotherapy for head and neck cancer. Int J Radiat Oncol Biol Phys 2010;78:1026–32Google Scholar
18Oates, JE, Clark, JR, Read, J, Reeves, N, Gao, K, Jackson, M et al. Prospective evaluation of quality of life and nutrition before and after treatment for nasopharyngeal carcinoma. Arch Otolaryngol Head Neck Surg 2007;133:533–40Google Scholar
19Nguyen, NP, North, D, Smith, HJ, Dutta, S, Alfieri, A, Karlsson, U et al. Safety and effectiveness of prophylactic gastrostomy tubes for head and neck cancer patients undergoing chemoradiation. Surg Oncol 2006;15:199–203Google Scholar
20Wiggenraad, RG, Flierman, L, Goossens, A, Brand, R, Verschuur, HP, Croll, GA et al. Prophylactic gastrostomy placement and early tube feeding may limit loss of weight during chemoradiotherapy for advanced head and neck cancer, a preliminary study. Clin Otolaryngol 2007;32:384–90Google Scholar
21Terrell, JE, Ronis, DL, Fowler, KE, Bradford, CR, Chepeha, DB, Prince, ME et al. Clinical predictors of quality of life in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 2004;130:401–8Google Scholar
22El-Deiry, MW, Futran, ND, McDowell, JA, Weymuller, EA Jr, Yueh, B. Influences and predictors of long-term quality of life in head and neck cancer survivors. Arch Otolaryngol Head Neck Surg 2009;135:380–4Google Scholar