COMPARISON OF NUTRITIONAL OUTCOMES AND COMPLICATIONS BETWEEN ENDOSCOPIC-ASSISTED NASOGASTRIC TUBE FEEDING AND SURGICAL FEEDING ENTEROSTOMY IN PATIENTS WITH OBSTRUCTED, LOCALLY ADVANCED ESOPHAGEAL CANCER UNDERGOING CHEMORADIATION THERAPY papawee.c@gmail.com

 

COMPARISON OF NUTRITIONAL OUTCOMES AND COMPLICATIONS BETWEEN ENDOSCOPIC-ASSISTED NASOGASTRIC TUBE FEEDING AND SURGICAL FEEDING ENTEROSTOMY IN PATIENTS WITH OBSTRUCTED, LOCALLY ADVANCED ESOPHAGEAL CANCER UNDERGOING CHEMORADIATION THERAPY

4

Thailand

Oral or Poster

Esophageal cancer (EC) is frequently diagnosed at a locally advanced stage, commonly presents with dysphagia and malnutrition, which can affect treatment tolerance and outcomes. Enteral feeding is essential during chemoradiation (CRT), particularly for patients who cannot maintain adequate oral intake. Although nasogastric tube (NGT) and surgical feeding enterostomy (SE) are commonly used methods, the optimal feeding route remains unclear.

We retrospectively reviewed EC patients with near-complete esophageal obstruction who underwent enteral access before CRT at King Chulalongkorn Memorial Hospital (2016–2024). Patients receiving endoscopic-assisted NGT or SE were assessed for nutritional outcomes—body weight and Prognostic Nutritional Index (PNI)—at four time points: pre-placement, during CRT, and 1 and 3 months post-CRT. Time to CRT initiation and rates of oral intake resumption were also analyzed.

Of 149 patients (NGT: 121; SE: 28), both groups showed declines in weight and PNI during CRT. SE patients had greater weight loss during CRT (−5.5% ± 4.8% vs. −1.5% ± 5.5%, p = 0.0006). By 3 months post-CRT, both groups showed weight recovery. NGT patients had a shorter waiting time to start CRT (18.1 ± 15.2 vs. 32.8 ± 29.6 days, p = 0.0003) and more frequently resumed oral intake post-treatment (44.6% vs. 17.8%, p = 0.009).

In EC patients with near-complete obstruction, NGT feeding provides comparable nutritional outcomes to SE but allows significantly faster CRT initiation and higher oral intake recovery rates, supporting its use as the preferred enteral access in time-sensitive settings.