Endoscopic palliation of malignant dysphagia

In patients with obstructive tumors of the esophagus and who cannot undergo curative surgery, endoscopic palliative methods can provide a quick relief of dysphagia with subsequent improvement of nutritional status. The technical success rate is as high as 95% for intubation and 100% for laser therapy. Both methods have their specific indications. Intubation is often able to provide quick and definitive palliation while laser therapy requires several sessions and relapses of obstruction are frequent. On the other hand, intubation carries a high risk of perforation (8.7%), and laser appears to be safer (1.7% perforation). Both methods can be combined in many instances, and their association with afterloading or external beam radiation therapy can be beneficial. Even if the overall survival rate is only 6 to 7 months, the improvement of the quality of life is the priority goal of these methods.