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Value of Percutaneous Radiologic Gastrostomy for Patients with Advanced Esophageal Cancer

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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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Disclosures

There are no conflicts of interest.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan

    Keitaro Sofue MD, PhD, Yoshito Takeuchi MD, PhD, Masakatsu Tsurusaki MD, PhD, Kentaro Shibamoto MD, Noriaki Sakamoto MD, PhD, Miyuki Sone MD, PhD & Yasuaki Arai MD, PhD

  2. Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

    Keitaro Sofue MD, PhD, Masakatsu Tsurusaki MD, PhD, Noriaki Sakamoto MD, PhD, Kazuhiro Kitajima MD, PhD & Kazuro Sugimura MD, PhD

Authors
  1. Keitaro Sofue MD, PhD
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  2. Yoshito Takeuchi MD, PhD
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  3. Masakatsu Tsurusaki MD, PhD
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  4. Kentaro Shibamoto MD
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  9. Yasuaki Arai MD, PhD
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Correspondence to Keitaro Sofue MD, PhD.

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Sofue, K., Takeuchi, Y., Tsurusaki, M. et al. Value of Percutaneous Radiologic Gastrostomy for Patients with Advanced Esophageal Cancer. Ann Surg Oncol 23, 3623–3631 (2016). https://doi.org/10.1245/s10434-016-5276-2

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  • DOI: https://doi.org/10.1245/s10434-016-5276-2

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