(A597) Percutaneous Endoscopic Gastrostomy vs Nasogastric Feeding for Early Nutrition in Head and Neck Cancer

Introduction: Prevention of post-operative weight loss in head and neck cancer patients often involves tube feeding via percutaneous endoscopic gastrostomy (PEG) or nasogastric (NG) tubes. Limited evidence exists on the efficacy of these methods, and no clear guidelines favor one over the other. This study compares post-operative weight loss trends in oral cancer patients using PEG vs. NG tubes and evaluates factors influencing selection of feeding route.

Methods: A retrospective cohort was conducted in which a total of 71 oral cancer patients who received enteral feeding following surgical resection at Aga Khan University Hospital were included, with 37 patients using PEG tubes and 34 using NG tubes. Weight loss was assessed at 1, 3, and 6 months postoperatively. Patient demographics, tumor characteristics, and comorbidities were also recorded.

Results: At 1 month, mean weight loss was 3.91 kg (NG) and 4.96 kg (PEG) (p = 0.43). By 3 months, weight loss increased to 4.93 kg (NG) and 7.51 kg (PEG) (p = 0.10), and at 6 months, 6.67 kg (NG) and 9.60 kg (PEG) (p = 0.19). Advanced tumor stages were significantly associated with PEG tube use (p = 0.01).

Conclusions: No significant difference in weight loss outcomes was observed between PEG and NG tube feeding, notion that PEG feeding is always superior needs revisiting. Patients with advanced tumor stages were more likely to require PEG tubes. Future research should explore long-term nutritional and functional outcomes to inform evidence-based guidelines.