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- W2977972005 abstract "Purpose: Percutaneous Endoscopic Gastrostomy (PEG) tube placement has become a preferred alternate route of nutritional support for patients with oropharyngeal and esophageal cancer. PEG tube exit site metastases is a rare yet major complication of this procedure. We evaluated the significance of utilizing an overtube during endoscopic PEG tube placement and its possible role in prevention of cancer metastases. We also report a case of PEG site metastases in a patient with advanced squamous cell carcinoma of the tongue at our institution. Methods: We performed a PUBMED literature search for the years 1962 to present, and reviewed the available English literature. A 53-year-old male was referred to our service with squamous cell carcinoma of the tongue. He underwent PEG tube placement after local disease recurrence involving the larynx. Six months after tube placement, he developed a friable mass at the exit site of the PEG tube. Biopsy of this mass demonstrated tumor histologically similar to the previously resected tongue and laryngeal tumor. He progressed to have oropharyngeal, axillary, and gastric metastases of disease. Results: Eighteen cases of PEG tube site metastases occurring in patients with oropharyngeal and esophageal carcinoma were reviewed. Seventeen patients underwent PEG placement by the conventional “pull” technique and one patient had a retrograde endoscopy performed through a stoma site. No cases reported the use of an overtube during endoscopic PEG tube placement. We performed a power calculation for a prospective, randomized trial assuming a 1% incidence of PEG site metastases in patients with oropharyngeal and esophageal malignancy. To demonstrate a 50% reduction in PEG site metastases utilizing an overtube, a total of 1240 patients would need to be included to achieve statistical significance with a p value of <0.05. Conclusions: Cancer metastatic to a gastrostomy site is a rarely reported yet serious complication of PEG tube placement in patients with oropharyngeal and esophageal cancer. The use of an overtube during endoscopic PEG tube placement to prevent direct implantation of malignant cells by means of instrumentation warrants further investigation." @default.
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- W2977972005 date "2005-09-01" @default.
- W2977972005 modified "2023-10-15" @default.
- W2977972005 title "Metastasis of a Head and Neck Carcinoma to a Percutaneous Gastrostomy Site" @default.
- W2977972005 doi "https://doi.org/10.14309/00000434-200509001-00670" @default.
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