Percutaneous endoscopic gastrostomy in the cancer patient.

A retrospective analysis of all patients with malignancy undergoing percutaneous endoscopic gastrostomy (PEG) was undertaken. PEG was attempted in 42 cancer patients from a total of 142 patients and successful in 38 (90.5%). The success rate in completing this procedure in cancer patients was significantly less than in noncancer patients (P = 0.04). The most common malignancy was oral-pharyngeal carcinoma (29%). Survival data was available in 35 of 38 patients (92%). Three patients died in less than one month. Forty six per cent of the patients survived three months or longer and 20 per cent 1 year or longer. The majority of the patients (68%) were able to return home after the PEG. There was no mortality related to the procedure. Local anesthesia was used in 95 per cent of the procedures. The major concerns derived from the study are the short-term survival in a small number of patients and aspiration in selective patients. Attempts should be made to identify these patients and avoid PEG since its benefits will be limited. When used selectively, PEG can improve the quality of life of the cancer patient.