[Palliative and curative endoscopic treatment of cancer of the esophagus]

The most common indication for endoscopic treatment of oesophageal cancers is palliative, owing to their late diagnosis and high rate of inoperability. The aim is to maintain oesophageal permeability. Technical progress in tumoral reduction (ethanol necrosing injections, plain or argon electrocoagulation, laser), which can be combined to radiochemotherapy, has limited the use of other methods: dilatations have short-lived efficacy; inoperable oesotracheal fistula is the main indication for endoscopically inserted prosthesis. Curative endoscopy is indicated for localised and superficial tumours in patients who are judged unfit for surgery. Mucosectomy, photodynamic therapy, intracavitary brachytherapy or local injections of anticancer drugs can then be employed either alone or, more commonly, combined with one another and with general radiochemotherapy.