Unplanned Hospitalization and Percutaneous Endoscopic Gastrostomy Tube Use for Head and Neck Cancer
Year: 2026
Type: article
Study design: Observational Study
Abstract: PURPOSE There is a heterogeneous practice pattern in prophylactic percutaneous endoscopic gastrostomy (PEG) tube placement, and it is unclear whether increased hospitalization is driven by those with versus without prophylactic PEG tube. To address this knowledge gap, we performed an observational cohort study to evaluate the association of PEG tube with hospitalization and other clinical outcomes. METHODS Our single-institution database was queried for patients with nonmetastatic head and neck cancer diagnosed between October 2011 and December 2023 who received definitive radiation or chemoradiation. Fine-Gray multivariable analysis (MVA) was used for time to first hospitalization and oncologic outcomes, whereas Cox MVA was used for survival outcomes. Bonferroni correction was used for multiple comparisons. RESULTS A total of 560 patients were identified. The median follow-up was 44.9 months. Overall, 249 (44.5%) patients were hospitalized at least once. The most common reason for hospitalization was failure to thrive (n = 192 [33.9%]). When compared with prophylactic PEG tube, no PEG tube was associated with less hospitalization (adjusted hazard ratio [aHR], 0.64 [95% CI, 0.45 to 0.91]; P = .01), but not therapeutic PEG tube (aHR, 1.16 [95% CI, 0.84 to 1.59]; P = .38). There was no statistical significance in survival and oncologic outcomes among these groups. CONCLUSION Our study suggested that nearly half of the patients were hospitalized at least once, and the most common reason was failure to thrive. Those who never had PEG tube had the lowest hospitalization rate, whereas prophylactic PEG tube was not associated with less hospitalization compared with those with therapeutic PEG tube.
Source: JCO oncology advances.
DOI: 10.1200/oa-26-00054
Authors: Sung Jun Ma, Daniel Alvarez, Krithik Tella, Jacob Wells, Alec Kotler, Darien Reed, Kevin Agner, Om Desai, Matthew Nguyen, Andrew Koempel, Simeng Zhu, Priyanka Bhateja, Emile Gogineni, David Konieczkowski, Darrion Mitchell, Sachin Jhawar, John Grecula, Lauren Miller, James Rocco, Marcelo Bonomi, Dukagjin Blakaj
Language: English
Topic: Head and Neck Cancer Studies
Subfield: Otorhinolaryngology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7172452499