BACKGROUND AND AIMS Metastasis to the gastrostomy site in patients with upper aerodigestive tract (UADT) malignancies is a rare but devastating adverse event that has been poorly described. Our aim was to determine the overall incidence and clinicopathologic characteristics observed with development of gastrostomy site metastasis in patients with UADT cancers. METHODS This was a systematic review and meta-analysis of 6138 studies retrieved from Medline, EMBASE, CINAHL, and the Cochrane Register after being queried for studies including gastrostomy site metastasis in patients with UADT malignancies. RESULTS The final analysis included 121 studies. Pooled analysis showed an overall event rate gastrostomy site metastasis of .5% (95% confidence interval [CI], .4%-.7%). Subgroup analysis showed an event rate of .56% (95% CI, .40%-.79%) with the pull technique and .29% (95% CI, .15%-.55%) with the push technique. Clinicopathologic characteristics observed with gastrostomy site metastasis were late-stage disease (T3/T4) (57.8%), positive lymph node status (51.2%), and no evidence of systemic disease (M0) (62.8%) at initial presentation. The average time from gastrostomy placement to diagnosis of metastasis was 7.78 ± 4.9 months, average tumor size on detection was 4.65 cm (standard deviation, 2.02), and average length of survival was 7.26 months (standard deviation, 6.23). CONCLUSIONS Gastrostomy site metastasis is a rare but serious adverse event that occurs at an overall rate of .5%, particularly in patients with advanced-stage disease, and is observed with a very poor prognosis. These findings emphasize a need for clinical practice guidelines to include a regular assessment of the PEG site and highlight the importance of detection and management of gastrostomy site metastasis by the multidisciplinary care oncology team.

中文翻译：

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从上消化道恶性肿瘤转移到胃造口的位置：系统评价和荟萃分析。

背景与目的上消化道恶性肿瘤患者胃造口术部位的转移是一种罕见但破坏性的不良事件，至今未得到充分描述。我们的目标是确定UADT癌症患者随着胃造口术部位转移的发展而观察到的总体发病率和临床病理特征。方法本研究是对6138项研究的系统评价和荟萃分析，这些研究从MEDDT，EMBASE，CINAHL和Cochrane登记表中检索到，研究内容包括UADT恶性肿瘤患者的胃造口术部位转移。结果最终分析包括121项研究。汇总分析显示，胃造口术部位转移的总体事件发生率为0.5％（95％置信区间[CI]，0.4％-。7％）。亚组分析显示事件发生率为0.56％（95％CI，.40％-）。使用拉动技术的用户占79％），使用拉动技术的用户占0.29％（95％CI，0.15％-。5％）。胃造口术部位转移观察到的临床病理特征为晚期疾病（T3 / T4）（57.8％），淋巴结状态阳性（51.2％），在初次出现时无全身疾病的证据（M0）（62.8％）。从胃造口术到转移诊断的平均时间为7.78±4.9个月，检测到的平均肿瘤大小为4.65 cm（标准差，2.02），平均生存时间为7.26个月（标准差，6.23）。结论胃造口术部位转移是一种罕见但严重的不良事件，总发生率为0.5％，尤其是在晚期疾病患者中，预后很差。