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Incidence of abdominal wall metastasis complicating PEG tube placement in untreated head and neck cancer.
Gastrointest Endosc. 2005 Nov; 62(5):708-11; quiz 752, 753.GE

Abstract

BACKGROUND

Abdominal wall metastasis after PEG tube placement has been reported in patients with head and neck cancer. The incidence of this occurrence is unknown.

OBJECTIVE

Evaluation of the incidence of abdominal wall metastasis as a complication of PEG tube placement in patients with head and neck cancer.

DESIGN

Retrospective chart review.

SETTING

H. Lee Moffitt Cancer Center and Research Institute, Nutritional Support Services.

SUBJECTS

Head and neck cancer patients requiring nutritional support with PEG tube placement.

RESULTS

Of the 304 patients with head and neck cancer, 218 had active disease with a viable tumor in the oropharynx or hypopharynx at the time of PEG placement. Two of these patients, both with active disease (0.92%), developed a PEG site metastasis.

CONCLUSION

There is a small but definite risk for tumor implantation in the gastrostomy site when using the pull technique in patients with active head and neck cancer. Careful assessment of the oropharynx and hypopharynx before PEG tube placement and the use of alternative techniques for enteral access in patients with untreated or residual malignancy are recommended to minimize this risk. Use of other percutaneous techniques that do not involve traversing the hypopharynx with the catheter may help to prevent tumor translocation. When head and neck cancers metastasize to the gastrostomy site, patient survival appears limited even with extensive resection.

Authors+Show Affiliations

Department of Internal Medicine, University of South Florida, College of Medicine, Nutritional Support Services, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

16246684

Citation

Cruz, Irma, et al. "Incidence of Abdominal Wall Metastasis Complicating PEG Tube Placement in Untreated Head and Neck Cancer." Gastrointestinal Endoscopy, vol. 62, no. 5, 2005, pp. 708-11; quiz 752, 753.
Cruz I, Mamel JJ, Brady PG, et al. Incidence of abdominal wall metastasis complicating PEG tube placement in untreated head and neck cancer. Gastrointest Endosc. 2005;62(5):708-11; quiz 752, 753.
Cruz, I., Mamel, J. J., Brady, P. G., & Cass-Garcia, M. (2005). Incidence of abdominal wall metastasis complicating PEG tube placement in untreated head and neck cancer. Gastrointestinal Endoscopy, 62(5), 708-11; quiz 752, 753.
Cruz I, et al. Incidence of Abdominal Wall Metastasis Complicating PEG Tube Placement in Untreated Head and Neck Cancer. Gastrointest Endosc. 2005;62(5):708-11; quiz 752, 753. PubMed PMID: 16246684.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence of abdominal wall metastasis complicating PEG tube placement in untreated head and neck cancer. AU - Cruz,Irma, AU - Mamel,Jay J, AU - Brady,Patrick G, AU - Cass-Garcia,Meg, PY - 2005/01/04/received PY - 2005/06/08/accepted PY - 2005/10/26/pubmed PY - 2006/2/8/medline PY - 2005/10/26/entrez SP - 708-11; quiz 752, 753 JF - Gastrointestinal endoscopy JO - Gastrointest Endosc VL - 62 IS - 5 N2 - BACKGROUND: Abdominal wall metastasis after PEG tube placement has been reported in patients with head and neck cancer. The incidence of this occurrence is unknown. OBJECTIVE: Evaluation of the incidence of abdominal wall metastasis as a complication of PEG tube placement in patients with head and neck cancer. DESIGN: Retrospective chart review. SETTING: H. Lee Moffitt Cancer Center and Research Institute, Nutritional Support Services. SUBJECTS: Head and neck cancer patients requiring nutritional support with PEG tube placement. RESULTS: Of the 304 patients with head and neck cancer, 218 had active disease with a viable tumor in the oropharynx or hypopharynx at the time of PEG placement. Two of these patients, both with active disease (0.92%), developed a PEG site metastasis. CONCLUSION: There is a small but definite risk for tumor implantation in the gastrostomy site when using the pull technique in patients with active head and neck cancer. Careful assessment of the oropharynx and hypopharynx before PEG tube placement and the use of alternative techniques for enteral access in patients with untreated or residual malignancy are recommended to minimize this risk. Use of other percutaneous techniques that do not involve traversing the hypopharynx with the catheter may help to prevent tumor translocation. When head and neck cancers metastasize to the gastrostomy site, patient survival appears limited even with extensive resection. SN - 0016-5107 UR - https://www.unboundmedicine.com/medline/citation/16246684/Incidence_of_abdominal_wall_metastasis_complicating_PEG_tube_placement_in_untreated_head_and_neck_cancer_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(05)02311-4 DB - PRIME DP - Unbound Medicine ER -