Abstract | BACKGROUND: METHODS: RESULTS: In total, 2315 patients were included. The American Joint Committee on Cancer staging distribution was as follows: stage I, 2.1%; stage II, 4.4%; stage III, 14.7%; and stage IV, 77.3%. Among 1459 patients (63%) who received a gastrostomy tube (g-tube), placement was prophylactic in 52% and reactive in 48%. Among patients with stage III and IV disease, 58% received concurrent chemotherapy. The median follow-up was 43.7 months (range, 0.1-164 months). The g-tube dependence rate was 7% at 1 year and 3.7% at 2 years. Among 1238 patients with stage III and IV disease who received concurrent chemotherapy, the 1-year and 2-year rates of g-tube dependence were 8.6% and 4.4%, respectively. The 1-year g-tube dependence rate was 5% for patients with stage I and II disease; 5.2% for patients with stage III and IV, T1-T2/N0-N2 disease; and 10.1% for patients with stage III and IV, T3-T4 or N3 disease. On multivariate analysis, advanced age (odds ratio [OR], 1.066; P<.001), greater number of smoking pack-years (OR, 1.008; P=.04), advanced N-category (OR, 1.13; P=.049), and receipt of cytotoxic chemotherapy (OR, 2.26; P=.02) were predictive of g-tube dependence at 1 year. CONCLUSIONS: This multi-institution series of 2315 patients treated at 3 institutions demonstrates that modern nonsurgical therapy for oropharyngeal cancer is associated with a low rate of long-term g-tube dependence.
|
Authors | Jeremy Setton, Nancy Y Lee, Nadeem Riaz, Shao-Hui Huang, John Waldron, Brian O'Sullivan, Zhigang Zhang, Weij Shi, David I Rosenthal, Katherine A Hutcheson, Adam S Garden |
Journal | Cancer
(Cancer)
Vol. 121
Issue 2
Pg. 294-301
(Jan 15 2015)
ISSN: 1097-0142 [Electronic] United States |
PMID | 25286832
(Publication Type: Journal Article, Multicenter Study)
|
Copyright | © 2014 American Cancer Society. |
Topics |
- Adult
- Aged
- Aged, 80 and over
- Carcinoma, Squamous Cell
(complications, radiotherapy, surgery)
- Chemoradiotherapy
- Deglutition Disorders
(etiology, physiopathology)
- Enteral Nutrition
- Gastrostomy
(methods)
- Humans
- Logistic Models
- Middle Aged
- Neck Dissection
(adverse effects)
- Oropharyngeal Neoplasms
(complications, radiotherapy, surgery)
- Radiotherapy, Intensity-Modulated
(adverse effects)
- Retrospective Studies
- Risk Factors
|