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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 11/2016

01-10-2016 | Thoracic Oncology

Value of Percutaneous Radiologic Gastrostomy for Patients with Advanced Esophageal Cancer

Authors: Keitaro Sofue, MD, PhD, Yoshito Takeuchi, MD, PhD, Masakatsu Tsurusaki, MD, PhD, Kentaro Shibamoto, MD, Noriaki Sakamoto, MD, PhD, Kazuhiro Kitajima, MD, PhD, Miyuki Sone, MD, PhD, Kazuro Sugimura, MD, PhD, Yasuaki Arai, MD, PhD

Published in: Annals of Surgical Oncology | Issue 11/2016

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Abstract

Background

Nutritional management is important throughout the treatment period for esophageal cancer patients. This study aimed to evaluate the feasibility of percutaneous radiologic gastrostomy (PRG) and to investigate whether PRG can be applied for patients with advanced esophageal cancer.

Methods

In this study, 89 patients (74 men and 15 women) with advanced esophageal cancer underwent PRG using computed tomography and fluoroscopic guidance. These patients were unsuitable candidates for endoscopic intervention because of esophageal stricture. Primary placement of a mushroom-retained gastrostomy catheter was intended. The end points were technical success and complications after PRG as well as clinical outcomes and survival of the patients. These end points also were compared between the pre-chemoradiotherapy (pre-CRT) and post-CRT groups using the Chi square test, Fisher’s exact test, and the Wilcoxon rank sum test. The survival rate was calculated using the Kaplan–Meier method and compared using the log-rank test.

Results

All the patients had a successful PRG. The mushroom-tip gastrostomy catheter was primarily inserted in 77 patients (86.5 %) and finally achieved for all the patients. Complications occurred for 14 patients (15.7 %) including Dindo-Clavien classification grade 3 (1 catheter dislodgement), grade 2 (2 gastric hemorrhages), and grade 1 (7 skin infections and 4 oozing hemorrhages) complications. During the follow-up period (median, 6 months), 60 patients (67.4 %) died, giving a 12-month survival rate of 37.7 %. Gastrostomy removal was more common in the pre-CRT group (P = 0.011). The pre-CRT group had higher survival rates than the post-CRT group (P = 0.021).

Conclusions

Because PRG provided high technical success with limited complications, it can be used for patients with advanced esophageal cancer whose treatment plan involves multimodal therapy.
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Metadata
Title
Value of Percutaneous Radiologic Gastrostomy for Patients with Advanced Esophageal Cancer
Authors
Keitaro Sofue, MD, PhD
Yoshito Takeuchi, MD, PhD
Masakatsu Tsurusaki, MD, PhD
Kentaro Shibamoto, MD
Noriaki Sakamoto, MD, PhD
Kazuhiro Kitajima, MD, PhD
Miyuki Sone, MD, PhD
Kazuro Sugimura, MD, PhD
Yasuaki Arai, MD, PhD
Publication date
01-10-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 11/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5276-2

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