Clinical Oncology, Kent Oncology Centre, Maidstone Hospital, Maidstone, Kent, United Kingdom.
Head Neck. 2019 Jun;41(6):2007-2015. doi: 10.1002/hed.25652. Epub 2019 Jan 25.
Because of publication bias, there is uncertainty about the true incidence of tumor seeding or implantation in patients with head and neck or oesophageal cancer undergoing percutaneous endoscopic gastrostomy (PEG) insertion.
In order to obtain a more reliable estimate of risk, a systematic review was undertaken. Randomized or non-randomized studies and case reports were identified by electronic searching. A risk of bias assessment was carried out for each study.
Ninety-eight cases from 74 published case reports and 1 unpublished case were identified. Synchronous distant metastases were present in 37%. Analysis of case series (6192 patients) considered to carry a moderate risk of bias suggests an incidence of seeding after PEG insertion of 0.32%. Studies carrying a lower risk of bias indicate a risk of seeding closer to 1 in 2000.
The true risk of seeding after PEG insertion is probably less than 1 in 1000.
由于发表偏倚的存在，对于接受经皮内镜胃造口术（PEG）置管的头颈部或食道癌患者，肿瘤播种或种植的确切发生率存在不确定性。
为了获得更可靠的风险估计，进行了系统评价。通过电子搜索确定了随机或非随机研究和病例报告。对每项研究进行了偏倚风险评估。
从 74 篇已发表的病例报告和 1 篇未发表的病例中，共确定了 98 例病例。37%的患者同时存在远处转移。对被认为存在中度偏倚风险的病例系列分析（6192 例患者）表明，PEG 置管后发生播种的发生率为 0.32%。风险较低的研究表明，播种的风险接近每 2000 例中有 1 例。
PEG 置管后发生播种的真实风险可能低于每 1000 例中有 1 例。
