Head and neck cancer PEG site metastases: Association with PEG placement method

Head Neck. 2019 May;41(5):1508-1516. doi: 10.1002/hed.25564. Epub 2019 Jan 7.

Abstract

Background: Many patients with head and neck cancer (HNC) will require feeding tube placement for nutritional support using percutaneous endoscopic gastrostomy (PEG) tube. Rarely, HNC metastases have been reported at the PEG site, a morbidity associated with a poor outcome.

Methods: Along with a case report, an evaluation of PEG placement methods with metastases from the literature was completed along with a statistical analysis of the literature to determine PEG site metastases and method of placement correlations.

Results: The incidence of PEG metastases in patients with HNC with the "pull" method is statistically identical to that of patients receiving any other method for PEG placement.

Conclusions: When considering options for the placement of PEG tubes in patients with HNC, the "pull" method should not be considered as a technique which will put patients at risk for PEG site metastases more than any other method of placement.

Keywords: Gauderer-Ponsky; PEG site metastasis; head and neck cancer.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Biopsy, Needle
  • Enteral Nutrition / methods
  • Follow-Up Studies
  • Gastrostomy / adverse effects*
  • Gastrostomy / methods
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Neoplasm Invasiveness / pathology
  • Neoplasm Metastasis / pathology
  • Neoplasm Staging
  • Risk Assessment
  • Tomography, X-Ray Computed / methods
  • Tongue Neoplasms / pathology*
  • Tongue Neoplasms / surgery*