title: Feeding Tube Utilization in Patients with Salivary Gland Malignancies.
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.
authors: 1 Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA.
authors: Diane Wenhua
authors: DW
authors: Chen
authors: 2 Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Jan S
authors: JS
authors: Lewin
authors: 2 Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Li
authors: L
authors: Xu
authors: 2 Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Stephen Y
authors: SY
authors: Lai
authors: 3 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: G Brandon
authors: GB
authors: Gunn
authors: 3 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Clifton David
authors: CD
authors: Fuller
authors: 3 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.|4 Department of Clinical Oncology and Nuclear Medicine, Alexandria University, Alexandria, Egypt.
authors: Abdallah S R
authors: AS
authors: Mohamed
authors: 3 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Aasheesh
authors: A
authors: Kanwar
authors: 2 Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.|5 Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Erich M
authors: EM
authors: Sturgis
authors: 2 Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Katherine A
authors: KA
authors: Hutcheson
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000150:complications / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D004750:Enteral Nutrition / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy*
keywords: feeding tube; gastrostomy tube; salivary gland malignancy