Nutrición Hospitalaria 03024 / http://dx.doi.org/10.20960/nh.03024
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Trabajo Original

Feasibility, safety and outcome of endoscopic gastrostomy in patients with esophageal cancer


Ana Laranjo, Mariana Brito, Gonçalo Nunes, Carla Adriana Santos, Jorge Fonseca

Prepublicado: 2020-07-20
Publicado: 2020-08-07

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Background and aims: esophageal cancer (EC) is an important health problem worldwide with high morbidity and mortality. EC patients are likely to develop malnutrition. The aim of this study was to assess the feasibility and safety of endoscopic gastrostomy (PEG) feeding in EC cancer, and to identify risk factors associated with poor prognosis. Methods: a retrospective observational study was performed using records from EC patients referred for PEG. Age, gender, cancer histologic subtype, indication for gastrostomy, and mortality data were recorded. NRS 2002, body mass index (BMI), hemoglobin, serum albumin, transferrin and total cholesterol were collected at the day of PEG. An association between anthropometric, clinical and laboratorial data with patient survival was assessed. Results: data were obtained for forty-one EC patients (36 men and 5 women) aged 39-88 years (mean, 62 years). Gastrostomy was possible in all patients referred to PEG (27 patients selected for curative treatment and 14 patients for palliative nutrition). No major complications occurred. Mean survival after PEG was 18.1 months, and mortality rate at 3 months was 31.7 %. Most patients (34; 82.9 %) died under PEG feeding. Mean BMI was 21.3 kg/m2 and 14 patients (34.1 %) patients had low BMI. Serum albumin, transferrin and total cholesterol were low in 10 (24.4 %), 20 (48.8 %) and 18 (43.9 %) patients, respectively. Higher BMI (R = 0.30), serum albumin (R = 0.41) and transferrin (R = 0.47) tended to be positively correlated with survival (p < 0.005). Conclusions: PEG is a feasible and safe technique for enteral feeding in EC patients. Higher BMI, serum albumin and transferrin levels at admission predict a better outcome. Enteral feeding through PEG should be considered early in EC patients due to their higher risk of malnutrition, which is associated with shorter survival.

Palabras Clave: Esophageal cancer. Percutaneous endoscopic gastrostomy. Nutritional support.



Hu, Hong-Tao, Yuan, Hang, Guo, Chen-Yang, Yao, Quan-Jun, Geng, Xiang, Cheng, Hong-Tao, Ma, Jun-Li, Zhao, Yan, Jiang, Li, Zhao, Yu-Qing, Li, Hai-Liang (2021) Radiological gastrostomy: A comparative analysis of different image-guided methods. International Journal of Gastrointestinal Intervention
Ionescu, Vlad-Alexandru, Gheorghe, Gina, Oprita, Ruxandra, Stan-Ilie, Madalina, Dascalu, Raluca-Ioana, Zaharia, Ondin, Jinga, Viorel, Diaconu, Camelia Cristina, Constantinescu, Gabriel (2022) The Outcomes of Nutritional Support Techniques in Patients with Gastrointestinal Cancers. Gastroenterology Insights
Wong MCS, Hamilton W, Whiteman DC, Yiang JY, Qiao Y, Fung FDH, et al. Global Incidence and mortality of oesophageal cancer and their correlation with socioeconomic indicators temporal patterns and trends in 41 countries. Sci Rep 2018;8(1):4522.
DOI: 10.1038/s41598-018-19819-8
Yousefi M, Sharifi-Esfahani M, Pourgholam-Amiji N, Afshar M, Sadeghi-Gandomani H, Otroshi O, et al. Esophageal cancer in the world: incidence, mortality and risk factors. Biomed Res Ther 2018;5(7):2504-17.
DOI: 10.15419/bmrat.v5i7.460
Huang FL, Yu SJ. Esophageal cancer: Risk factors, genetic association, and treatment. Asian J Surg 2018;41(3):210-5.
DOI: 10.1016/j.asjsur.2016.10.005
Ogino H, Akiho H. Usefulness of percutaneous endoscopic gastrostomy for supportive therapy of advanced aerodigestive cancer. World J Gastrointest Pathophysiol 2013;4(4):119-25.
DOI: 10.4291/wjgp.v4.i4.119
Dai Y, Li C, Xie Y, Liu X, Zhang J, Zhou J, et al. Interventions for dysphagia in oesophageal cancer. Cochrane database Syst Rev 2014;(10):CD005048.
DOI: 10.1002/14651858.CD005048.pub4
Min YW, Jang EY, Jung JH, Lee H, Min BH, Lee JH, et al. Comparison between gastrostomy feeding and self-expandable metal stent insertion for patients with esophageal cancer and dysphagia. PLoS One 2017;12(6):e0179522.
DOI: 10.1371/journal.pone.0179522
Bozzetti F. Screening the nutritional status in oncology: a preliminary report on 1,000 outpatients. Support care cancer. Off J Multinatl Assoc Support Care Cancer 2009;17(3):279-84.
DOI: 10.1007/s00520-008-0476-3
Lorimer PD, Motz BM, Watson M, Trufan SJ, Prabhu RS, Hill JS, et al. Enteral Feeding Access Has an Impact on Outcomes for Patients with Esophageal Cancer Undergoing Esophagectomy: An Analysis of SEER-Medicare. Ann Surg Oncol 2019;26(5):1311-9.
DOI: 10.1245/s10434-019-07230-0
Bozzetti F, Arends J, Lundholm K, Micklewright A, Zurcher G, Muscaritoli M. ESPEN Guidelines on Parenteral Nutrition: non-surgical oncology. Clin Nutr 2009;28(4):445-54.
DOI: 10.1016/j.clnu.2009.04.011
Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr 2017;36(1):11-48.
DOI: 10.1016/j.clnu.2016.07.015
Nunes G, Fonseca J, Barata AT, Dinis-Ribeiro M, Pimentel-Nunes P. Nutritional Support of Cancer Patients without Oral Feeding: How to Select the Most Effective Technique? GE - Port J Gastroenterol 2019:1-13.
DOI: 10.1159/000502981
Yagishita A, Kakushima N, Tanaka M, Takizawa K, Yamaguchi Y, Matsubayashi H, et al. Percutaneous endoscopic gastrostomy using the direct method for aerodigestive cancer patients. Eur J Gastroenterol Hepatol 2012;24(1):77-81.
DOI: 10.1097/MEG.0b013e32834dfd67
Rabie AS. Percutaneous endoscopic gastrostomy (PEG) in cancer patients; technique, indications and complications. Gulf J Oncolog 2010;(7):37-41.
Foster JM, Filocamo P, Nava H, Schiff M, Hicks W, Rigual N, et al. The introducer technique is the optimal method for placing percutaneous endoscopic gastrostomy tubes in head and neck cancer patients. Surg Endosc 2007;21(6):897-901.
DOI: 10.1007/s00464-006-9068-9
Lang K, ElShafie RA, Akbaba S, Koschny R, Bougatf N, Bernhardt D, et al. Percutaneous Endoscopic Gastrostomy Tube Placement in Patients with Head and Neck Cancer Treated with Radiotherapy. Cancer Manag Res 2020;12:127-36.
DOI: 10.2147/CMAR.S218432
Sieron HL, Eberle F, Gress TM, Mahnken AH, Wiegand S. Safety of Prophylactic Gastrostomy Tube Placement and Gastrostomy Tube Usage in Patients Treated by Radio(chemo)therapy for Head and Neck Cancer. Anticancer Res 2020;40(2):1167-73.
DOI: 10.21873/anticanres.14059
Zuercher BF, Grosjean P, Monnier P. Percutaneous endoscopic gastrostomy in head and neck cancer patients: indications, techniques, complications and results. Eur Arch Otorhinolaryngol 2011;268(4):623-9.
DOI: 10.1007/s00405-010-1412-y
Veitch AM, Vanbiervliet G, Gershlick AH, Boustiere C, Baglin TP, Smith LA, et al. Endoscopy in patients on antiplatelet or anticoagulant therapy, including direct oral anticoagulants: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guidelines. Endoscopy 2016;48(4):c1.
DOI: 10.1055/s-0042-122686
Dormann AJ, Wejda B, Kahl S, Huchzermeyer H, Ebert MP, Malfertheiner P. Long-term results with a new introducer method with gastropexy for percutaneous endoscopic gastrostomy. Am J Gastroenterol 2006;101(6):1229-34.
DOI: 10.1111/j.1572-0241.2006.00541.x
Fonseca J, Adriana C, Frois-Borges M, Meira T, Oliveira G, Santos JC. Ostomy metastasis after pull endoscopic gastrostomy: a unique favorable outcome. Nutr Hosp 2015;31(4):1879-81.
Powell-Tuck J, Hennessy EM. A comparison of mid upper arm circumference, body mass index and weight loss as indices of undernutrition in acutely hospitalized patients. Clin Nutr 2003;22(3):307-12.
DOI: 10.1016/S0261-5614(03)00009-8
Barosa R, Roque Ramos L, Santos CA, Pereira M, Fonseca J. Mid upper arm circumference and Powell-Tuck and Hennessy’s equation correlate with body mass index and can be used sequentially in gastrostomy fed patients. Clin Nutr 2018;37(5):1584-8.
DOI: 10.1016/j.clnu.2017.08.011
Cederholm T, Bosaeus I, Barazzoni R, Bauer J, Van Gossum A, Klek S, et al. Diagnostic criteria for malnutrition - An ESPEN Consensus Statement. Clin Nutr 2015;34(3):335-40.
DOI: 10.1016/j.clnu.2015.03.001
Miller KR, Bozeman MC. Nutrition therapy issues in esophageal cancer. Curr Gastroenterol Rep 2012;14(4):356-66.
DOI: 10.1007/s11894-012-0272-6
Xie S-H, Lagergren J. Risk factors for oesophageal cancer. Best Pract Res Clin Gastroenterol 2018;36-37:3-8.
DOI: 10.1016/j.bpg.2018.11.008
Grilo A, Santos CA, Fonseca J. Percutaneous endoscopic gastrostomy for nutritional palliation of upper esophageal cancer unsuitable for esophageal stenting. Arq Gastroenterol 2012;49(3):227-31.
DOI: 10.1590/S0004-28032012000300012
Anandavadivelan P, Lagergren P. Cachexia in patients with oesophageal cancer. Nat Rev Clin Oncol 2016;13(3):185-98.
DOI: 10.1038/nrclinonc.2015.200
Gupta B, Kumar N. Worldwide incidence, mortality and time trends for cancer of the oesophagus. Eur J Cancer Prev 2017;26(2):107-18.
DOI: 10.1097/CEJ.0000000000000249
Park RH, Allison MC, Lang J, Spence E, Morris AJ, Danesh BJ, et al. Randomised comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with persisting neurological dysphagia. BMJ 1992;304(6839):1406-9.
DOI: 10.1136/bmj.304.6839.1406

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