title: Risk of Esophageal Cancer Following Percutaneous Endoscopic Gastrostomy in Head and Neck Cancer Patients: A Nationwide Population-Based Cohort Study in Taiwan.
abstract: Esophageal cancers account for majority of synchronous or metachronous head and neck cancers. This study examined the risk of esophageal cancer following percutaneous endoscopic gastrostomy (PEG) in head and neck cancer patients using the Taiwan National Health Insurance Research Database. From 1997 to 2010, we identified and analyzed 1851 PEG patients and 3702 sex-, age-, and index date-matched controls. After adjusting for esophagitis, esophagus stricture, esophageal reflux, and primary sites, the PEG cohort had a higher adjusted hazard ratio (2.31, 95% confidence interval [CI] = 1.09-4.09) of developing esophageal cancer than the controls. Primary tumors in the oropharynx, hypopharynx, and larynx were associated with higher incidence of esophageal cancer. The adjusted hazard ratios were 1.49 (95% CI = 1.01-1.88), 3.99 (95% CI = 2.76-4.98), and 1.98 (95% CI = 1.11-2.76), respectively. Head and neck cancer patients treated with PEG were associated with a higher risk of developing esophageal cancer, which could be fixed by surgically placed tubes.
authors.affiliation: From the Department of Radiation Oncology (K-TL, C-SL, W-YH), Tri-Service General Hospital; Graduate Institute of Aerospace and Undersea Medicine (S-YL); and Division of Gastroenterology (W-KC), Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Kuen-Tze
authors.initials: KT
authors.lastname: Lin
authors.forename: Chun-Shu
authors.initials: CS
authors.lastname: Lin
authors.forename: Shih-Yu
authors.initials: SY
authors.lastname: Lee
authors.forename: Wen-Yen
authors.initials: WY
authors.lastname: Huang
authors.forename: Wei-Kuo
authors.initials: WK
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D016099:Endoscopy, Gastrointestinal; D004938:Esophageal Neoplasms / Q000556:secondary*; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000009:adverse effects* / Q000379:methods; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009366:Neoplasm Seeding; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013624:Taiwan