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Oesophageal SEMS — SCE Medical Oncology MCQ

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EasyGI CancersOesophageal SEMSSCE Medical Oncology

A 70-year-old man with oesophageal cancer develops progressive dysphagia from luminal tumour obstruction. He is not fit for further oncological treatment. What is the best palliative intervention for dysphagia?

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Correct answer: C — Self-expanding metallic stent (SEMS) insertion — provides rapid and sustained relief of dysphagia in inoperable oesophageal obstruction

SEMS insertion provides rapid palliation of malignant dysphagia (usually within 24-48 hours) for inoperable oesophageal cancer. It is preferred over rigid plastic stents (lower complication rates, easier insertion). Complications include: migration (~10%), tumour ingrowth/overgrowth (~15%), perforation (~2-5%) and GORD (for distal stents). For patients with longer prognosis (>3 months), brachytherapy may provide more durable relief. PEG/RIG feeding provides nutritional support but does not address dysphagia symptom directly.

Reference: NICE NG83 Oesophago-gastric cancer; BSG SEMS Guidelines; ESMO Supportive Care