Article Abstract

Gastrostomy tube insertion outcomes in South Australian head and neck cancer patients

Authors: Stephen Shih-Teng Kao, Matthew Marshall-Webb, Nuwan Dharmawardana, Andrew Foreman, Eng Hooi Ooi

Abstract

Background: Gastrostomies are important adjuncts in maintaining nutrition in head and neck cancer patients undergoing treatment. This study aims to investigate outcomes in head and neck cancer patients managed with gastrostomies.
Methods: A retrospective chart review of patients with mucosal head and neck squamous cell carcinoma (SCC) treated with non-surgical therapy, receiving gastrostomies between 2010 to 2015. The primary outcomes were complications following gastrostomy insertion stratified by insertion technique and classified with the Clavien-Dindo classification. Secondary outcomes included re-admission rates, weight changes and gastrostomy dependency.
Results: A total of 103 patients were identified, consisting of 81% males with a mean age of 58 years. A total of 59 complications occurred in 42% of patients following gastrostomy insertions. Radiological gastrostomies were associated with higher grade complications (15%) requiring surgical intervention under general anaesthesia. Mucositis and acute pain requiring supportive management were the most common indications for readmission. Patients treated with gastrostomies were found to have a median weight loss of 5 kg. Prophylactic gastrostomies demonstrated shorter period of gastrostomy dependency compared to reactive insertions (174 vs. 249 days).
Conclusions: Radiological gastrostomy insertions were associated with higher grade complications requiring surgical intervention. Higher pre-treatment weights were associated with higher post-treatment weights.