Feeding Tube Utilization in Patients with Salivary Gland Malignancies.

Feeding Tube Utilization in Patients with Salivary Gland Malignancies.

Otolaryngol Head Neck Surg. 2016 Aug 30;

Authors: Chen DW, Lewin JS, Xu L, Lai SY, Gunn GB, Fuller CD, Mohamed AS, Kanwar A, Sturgis EM, Hutcheson KA

Abstract
OBJECTIVES: To evaluate feeding tube utilization in patients with salivary gland malignancies (SGMs).
STUDY DESIGN: Case series with planned data collection.
SETTING: The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
SUBJECTS AND METHODS: Patients (N = 287) were sampled from an epidemiologic SGM registry during a 12-year period. Feeding tube history was retrospectively reviewed. Patients with outside locoregional therapy or palliative treatment were excluded. Enteral feeding and length of dependence were analyzed as a function treatment modality and site of SGM.
RESULTS: Of 287 patients, 79 (28%) required temporary nasogastric tube feeding (median duration: 13 days, interquartile range: 6-21). Among those 79, 30 (10% of total cohort) required conversion to percutaneous gastrostomy tube (G-tube). Median G-tube duration was 4.8 months (interquartile range: 3.7-13.1). G-tube placement was necessary only in patients receiving multimodality therapy (P < .001), and among those, 50% with SGMs arising from pharyngeal/laryngeal sites required G-tube, as compared with 8% to 19% of SGMs arising from all other sites (P < .01). At a median follow-up of 2.4 years, 9 (3%) of all SGM patients were G-tube dependent, but 14% (3 of 22) with laryngeal/pharyngeal sites treated with multimodality therapy remained chronically G-tube dependent.
CONCLUSION: While almost 30% of SGM survivors require a temporary nasogastric tube, G-tube utilization is uncommon, in roughly 10% of SGM overall. G-tube utilization appears exclusive to patients treated with multimodality therapy, and chronic gastrostomy remains high (14%) in patients with minor gland cancers arising in the pharynx/larynx, suggesting impetus for dysphagia prophylaxis in these higher-risk subsets, similar to patients treated for squamous cancers.

PMID: 27576681 [PubMed - as supplied by publisher]

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