HNSCC pts often need a PEG during their disease. While PEG is studied in depth for locally advanced disease, this is not the case for r/mHNSCC, where therapeutic PEG it supposed to compensate for impaired swallowing, aspiration and to improve the patient's nutrition status with a potential positive effect on outcome.
We retrospectively analyzed patients with r/mHNSCC referred for palliative systemic treatment between 2005 and 2015. Patients, disease and treatment characteristics were assessed, including the presence of PEG at the start of 1st-line systemic therapy. Known prognostic factors according to Argiris et al were assessed and considered for analysis. Correlation between survival and PEG status was calculated using Kaplan-Meier method and multivariate Cox regression models.
We included 110pts in our analysis. 100pts received first-line therapy. Forty-two patients (42%) had a PEG at the time of palliative 1st-line systemic treatment. Mean age was 61years (range 38-85). 84% of pts were male and 16% female. 80% had an ECOG PS of 0 or 1. Oropharynx, oral cavity, larynx and hypopharynx were the primary cancer sites in 29, 26, 20 and 16% respectively, with 9% other sites. Median survival from start of 1st line systemic treatment was 8.0months (95% CI, 6.5-12.0months). ECOG PS was the strongest prognostic factor in our cohort (HR = 2.55, p
The presence of PEG feeding tubes in patients with r/mHNSCC is an independent negative prognostic factor. Currently applied prognostic factors could be insufficient for an adequate adjusted multivariate analysis in r/mHNSCC. Presence or placement of PEG does not seem to prolong survival in this advanced patient population. These data is hypothesis generating. The impact can be important and outweigh other survival benefits due to systemic therapy.
Clinical trial identification
Legal entity responsible for the study
Cantonal Hospital St. Gallen
All authors have declared no conflicts of interest.