Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2006 Jul 4:4:38.
doi: 10.1186/1477-7819-4-38.

Endoscopic palliation of malignant dysphagia: a challenging task in inoperable oesophageal cancer

I E Katsoulis  1 , A Karoon, S Mylvaganam, J I Livingstone
Affiliations

Endoscopic palliation of malignant dysphagia: a challenging task in inoperable oesophageal cancer

I E Katsoulis et al. World J Surg Oncol. .

Abstract

Background: The main goal when managing patients with inoperable oesophageal cancer is to restore and maintain their oral nutrition. The aim of the present study was to assess the value of endoscopic palliation of dysphagia in patients with oesophageal cancer, who either due to advanced stage of the disease or co-morbidity are not suitable for surgery.

Patients and methods: All the endoscopic palliative procedures performed over a 5-year period in our unit were retrospectively reviewed. Dilatation and insertion of self-expandable metal stents (SEMS) were mainly used for tight circumferential strictures whilst ablation with Nd-YAG laser was used for exophytic lesions. All procedures were performed under sedation.

Results: Overall 249 palliative procedures were performed in 59 men and 40 women, with a median age of 73 years (range 35-93). The median number of sessions per patient was 2 (range 1-13 sessions). Palliation involved laser ablation alone in 24%, stent insertion alone in 22% and dilatation alone in 13% of the patients. In 41% of the patients, a combination of the above palliative techniques was applied. A total of 45 SEMS were inserted. One third of the patients did not receive any other palliative treatment, whilst the rest received chemotherapy, radiotherapy or chemoradiotherapy. Swallowing was maintained in all patients up to death. Four oesophageal perforations were encountered; two were fatal whilst the other two were successfully treated with covered stent insertion and conservative treatment. The median survival from diagnosis was 10.5 months (range 0.5-83 months) and the median survival from 1st palliation was 5 months (range 0.5-68.5 months).

Conclusion: Endoscopic interventions are effective and relatively safe palliative modalities for patients with oesophageal cancer. It is possible to adequately palliate almost all cases of malignant dysphagia. This is achieved by expertise in combination treatment.

PubMed Disclaimer

Figures

Figure 1
Figure 1
ASA score of patients.
Figure 2
Figure 2
Stage of oesophageal carcinoma.
Figure 3
Figure 3
Endoscopic modalities used to palliate dysphagia.
Figure 4
Figure 4
Other type of non-endoscopic palliative therapy was also used in 2/3 of patients.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Cancer Stats Monograph 2004. Cancer incidence, survival and mortality in the UK and EU. Cancer Research UK;
    1. Müller JM, Erasmi H, Stelzner , et al. Surgical therapy of oesophageal carcinoma. Br J Surg. 1990;77:845–57. - PubMed
    1. Reed CE. Comparison of different treatments for unresectable oesophageal cancer. World J Surg. 1995;19:828–35. doi: 10.1007/BF00299779. - DOI - PubMed
    1. Earlam R, Cuhna-Melo JR. Oesophageal squamous cell carcinoma: Critical review of surgery. Br J Surg. 1980;67:381–90. - PubMed
    1. Frenken M. Best palliation in oesophageal cancer: surgery, stenting, radiation, or what? Dis Esophagus. 2001;14:120–3. doi: 10.1046/j.1442-2050.2001.00168.x. - DOI - PubMed

LinkOut - more resources