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

de, Mary Katherine Montes; Nye, Anthony; Porter, Caroline; Collins, Justin; Satterfield, Corey; Schammel, Christine; Trocha, Steven D.

doi:10.1002/hed.25564

Cited by 6 publications

(10 citation statements)

References 71 publications

(139 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Poor nutrition has been linked with adverse outcomes in the HNSCC patients’ population, hence alternative nutritional support means have understandably been employed to improve life expectancy and overall outcome [ 3 ]. Moreover, the global benefits of enteral nutritional support have become well-established as an adjunctive component in the interdisciplinary management of primary HNSCC [ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Metastatic Squamous Cell Carcinoma From Primary Hypopharynx Source to Gastric Mucosa Presenting as Massive Gastrointestinal Bleeding

et al. 2023

View full text Add to dashboard Cite

Percutaneous endoscopic gastrostomy (PEG) is a relatively safe procedure that represents an important supportive adjunctive component for patients with primary head and neck squamous cell carcinoma (HNSCC). The HNSCC population is considered a high-risk group for developing critical nutritional deficiency due to a multitude of factors. Nevertheless, as the use of PEG in modern practice is gaining more popularity due to various indications, unusual complications have been increasingly reported. PEG site metastasis from primary HNSCC has emerged as a rare, yet serious oncological phenomenon that warrants careful consideration. The authors report an unusual case of squamous cell carcinoma (SCC) of the hypopharynx that metastasized to the gastric body mucosa through a PEG site. The metastatic SCC presented as massive gastrointestinal bleeding, and esophagogastroscopy revealed an ulcerated mass in the gastric body masquerading as a primary gastric adenocarcinoma. Histopathology and immunohistochemistry examination confirmed metastatic SCC which concurred with the patient’s primary hypopharyngeal SCC. The review of the updated literature revealed that a total of 121 cases of this rare oncological entity have been reported to date. Physicians need to be vigilant of the symptoms of PEG site metastasis to accurately diagnose and manage the care of this rare occurrence as it is associated with poor prognosis.

show abstract

Section: Discussionmentioning

confidence: 99%

“…PEG site metastasis from primary HNSCCs is a rare but serious clinical entity [ 3 , 8 , 9 ]. According to a recent systematic review conducted by Siu et al in 2019 [ 8 ], a total of 121 cases of PEG site metastasis from various primary upper aerodigestive cancers were documented [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Metastatic Squamous Cell Carcinoma From Primary Hypopharynx Source to Gastric Mucosa Presenting as Massive Gastrointestinal Bleeding

et al. 2023

View full text Add to dashboard Cite

show abstract

“…This possibility is also why the ESGE guidelines recommend the “push” technique in patients with HNC cancer 7 . However, a review of 62 case reports of PEG site metastasis showed that metastasis could occur even after introducer PEG placement 20 . Further studies are needed to gain a fuller understanding of HNC tumor seeding to gastrostomies.…”

Section: Discussionmentioning

confidence: 99%

“…7 However, a review of 62 case reports of PEG site metastasis showed that metastasis could occur even after introducer PEG placement. 20 Further studies are needed to gain a fuller understanding of HNC tumor seeding to gastrostomies. The high number of patients and procedures included in the analysis represent important strengths of the study.…”

Section: Discussionmentioning

confidence: 99%

Complications of Gastrostomy Tubes in Patients With Head and Neck Cancer

et al. 2022

View full text Add to dashboard Cite

Objectives: Head and neck cancers (HNCs) include various malignant tumors of the upper aerodigestive tract. Due to their anatomical location, HNCs can cause obstruction, odynophagia, or trismus, leading to dysphagia. In addition, this patient group may be vulnerable to treatment side effects both by surgery and oncological treatment, exposing the patients to an even higher risk of malnutrition. The risk of malnourishment is often resolved by applying a feeding gastrostomy tube. The present study aims to identify complication rates after percutaneous endoscopic gastrostomy (PEG) and open gastrostomy (OG) in patients treated for HNC in a high-volume center.Study Design: Retrospective cohort study.Methods: A retrospective cohort study of all patients treated for a new diagnosis of HNC at the Department of Otorhinolaryngology and Head and Neck Surgery at Karolinska University Hospital between January 1, 2000 and December 31, 2018 in whom gastrostomy was performed.Results: Regarding tumor location, 165 (56.7%) were in the pharynx, 68 (23.4%) in the oral cavity, 57 (19.6%) in the larynx, and 1 (0.3%) in the nasal cavity. PEG was performed in 240 (82.5%) and OG in 51 (17.5%) patients. The overall complication rate was 28.2%: 64 (26.7%) among PEG patients and 18 (35.3%) among OG patients. The incidence of major complications was 3.1%.Conclusions: Our study confirms that enteral feeding via gastrostomy is a safe method, regardless of the technique used (PEG or OG), with a low rate of major complications and no mortality linked to the procedure.

show abstract

“…7 Different methods of PEG placement do not differ significantly in the incidence of development of abdominal wall metastasis. 8 A study evaluating…”

Section: Descriptionmentioning

confidence: 99%