Predicting the need for prophylactic gastrostomy in major head and neck cancer surgery: The PEG score

Abstract

BackgroundTo elaborate a preoperative score to predict the necessity of enteral nutrition at 28 days postoperatively in patients undergoing head and neck surgery.MethodsA total of 424 patients with oral cavity, oropharyngeal, laryngeal, and hypopharyngeal carcinoma were retrospectively enrolled and analyzed to identify preoperative predictors of prolonged postsurgical enteral feeding which were used to create a prediction model with an easy‐to‐use nomogram.ResultsFive preoperative variables (body mass index, previous radiotherapy, preoperative dysphagia, type of surgery, flap reconstruction) were found to be independent predictive factors and were used to create a prediction model named PEG score together with the related nomogram. Accuracy, F1, and the area under the curve (AUC) were 0.74, 0.83, and 0.74. Different decision thresholds can be used to vary the sensitivity and specificity.ConclusionsThe PEG score showed high prediction performances for modeling the need for enteral nutrition at 28 days postoperatively. Prospective studies are needed to define a personalized nutrition protocol.

Oncological and functional outcome after laryngectomy for laryngeal and hypopharyngeal cancer: a population-based analysis in Germany from 2001 to 2020

“…Hence, an analysis of the causal relationship between the detected predictive factors and outcome was not possible. Furthermore, several factors that might have influence on oncological and functional outcome, for instance like comorbidity, body mass index and socioeconomic factors, were not analyzed but would be of interest for future studies 39 – 41 . To directly compare laryngectomy ± postoperative radio(chemo)therapy to non-surgical treatment concepts is difficult in a retrospective population-based setting due to the selection bias 19 , 20 , but is planned as a next study in the Thuringian setting.…”