Endoscopic palliation of esophageal cancer: a narrative review apart from stenting

Objective: The objective of this paper to provide a narrative review that focuses on endoluminal ablative options for palliative esophageal cancer treatment such as photodynamic therapy (PDT), cryotherapy, YAG laser therapy, and argon plasma coagulation (APC). Esophageal stenting will be discussed elsewhere in this special series. Background: Esophageal cancer remains the eighth-most common cancer and the sixth-most common cause of death worldwide. Unfortunately, most patients are diagnosed at advanced stages, and non-surgical palliative treatment modalities has become an important part of the physicians' armamentarium. In addition to esophageal stenting, endoluminal treatment options have become increasingly important in addition to chemotherapy and radiation, as these modalities allow dysphagia, risk of aspiration, and resulting malnutrition to be resolved to varying degrees. Methods: Literature research, focusing on original research, was conducted. Results of studies are summarized and reviewed with a proposed treatment algorithm for palliation of dysphagia due to esophageal cancer. Conclusions: Several endoluminal ablative techniques have been developed for palliative treatment of advanced esophageal cancer, each with its own advantages and weaknesses. Physicians treating esophagus cancer should be familiar with and have different therapeutic options available to them. A multi-modal or multi-session approach may need to be undertaken to get optimal results.