title: Developing a protocol for gastrostomy tube insertion in patients diagnosed with head and neck cancer.
abstract: Selecting patients with head and neck cancer requiring a pretreatment gastrostomy feeding tube is not straightforward. The nutritional status and functional deficits associated with the cancer, its treatment, and the long-term side effects predicate the need for gastrostomy tube placement. However, gastrostomy tubes are not without morbidity and are an added burden to the patient. The aim of this retrospective case series review was to evaluate the clinical characteristics of newly diagnosed patients with head and neck cancer treated with curative intent having gastrostomy placement, with the intent of developing a protocol to help with the timely selection of patients for pretreatment gastrostomy insertion. A gastrostomy tube was placed in 32%. A regression model identified 5 independent predictors (P < .001) to predict gastrostomy tube placement: overall clinical stage, tumor site, clinical T stage, patient age, and clinical N stage. A protocol to help the multidisciplinary team to decide whether a pretreatment gastrostomy tube should be placed is suggested.
authors.affiliation: Aintree University Hospital, Liverpool, United Kingdom.
authors.forename: Syed F
authors.initials: SF
authors.lastname: Habib
authors.affiliation: Aintree University Hospital, Liverpool, United Kingdom.
authors.forename: Suhail
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Aintree University Hospital, Liverpool, United Kingdom.
authors.forename: Rachel
authors.initials: R
authors.lastname: Skelly
authors.affiliation: Aintree University Hospital, Liverpool, United Kingdom.
authors.forename: Kavita
authors.initials: K
authors.lastname: Bhatt
authors.affiliation: Aintree University Hospital, Liverpool, United Kingdom.
authors.forename: Bhaveshree
authors.initials: B
authors.lastname: Patel
authors.affiliation: Aintree University Hospital, Liverpool, United Kingdom.
authors.forename: Derek
authors.initials: D
authors.lastname: Lowe
authors.affiliation: Aintree University Hospital, Liverpool, United Kingdom.
authors.forename: Julian
authors.initials: J
authors.lastname: Tuson
authors.affiliation: Aintree University Hospital, Liverpool, United Kingdom. Electronic address: snrogers.aintree@gmail.com.
authors.forename: Simon N
authors.initials: SN
authors.lastname: Rogers
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D002985:Clinical Protocols; D005260:Female; D005774:Gastrostomy / Q000592:standards*; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D015996:Survival Rate; D016896:Treatment Outcome