Risk factors analysis for percutaneous endoscopic gastrostomy in patients with oral cancer: a retrospective study

The indications for percutaneous endoscopic gastrostomy (PEG) in oral cancer patients remain unclear. This study aimed to analyze the relevant clinical characteristics of oral cancer surgical patients undergoing PEG.

Clinical data of oral cancer patients who underwent PEG from July 2020 to June 2021 at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine were collected. Patients with PEG usage exceeding 1 month were assigned to the case group, while those with PEG usage equal to or less than 1 month were assigned to the control group. Univariate analysis and logistic regression analysis were employed to identify independent factors influencing the differential usage of PEG and the predictive value of relevant factors was assessed using receiver operating characteristic (ROC) curve analysis.

A total of 104 cases of oral cancer surgical patients undergoing PEG were included. Univariate analysis revealed significant effects of tongue/pharyngeal resection during surgery (P=0.03), postoperative combined radiotherapy and chemotherapy (P=0.002), as well as advanced tumor stage (T stage) (P<0.001) and node stage (N stage) (P<0.001) of oral cancer on PEG usage. Logistic regression analysis identified postoperative combined radiotherapy and chemotherapy, T stage, and N stage as independent factors influencing PEG usage. The combined predictive model yielded an area under the ROC curve (AUC) of 0.832 (P<0.001), with sensitivity and specificity of 0.767 and 0.778, respectively.

The results suggest that oral cancer patients with tongue/pharyngeal resection during surgery, postoperative combined radiotherapy and chemotherapy, and advanced T and N stages of oral cancer may have a stronger indication for PEG.