Breakout Session: Palliation of Esophago-Gastric Malignancies
Robert Shen, MD—Chair
Mayo Clinic
Bridget N. Fahy, MD
University of New Mexico
Managing Obstruction
Conclusions:
• Palliation starts with patient • Stents +/- brachy or chemotherapy effectively relieves esophageal obstruction • Surgical or endoscopic treatments provide similar palliation of gastric obstruction • Limited role for palliative resection • Multimodal pharmacotherapy key adjunct to procedural interventions
Jennifer Yon-Li Wo, MD
Massachusetts General Hospital
Managing Bleeding
Conclusions:
• Rates of re-bleed are high and prognosis generally poor after endoscopic and IR therapies
- ideally utilized as a bridge to therapeutic options
• Treatment Algorithm:
- For Slow drift, consider RT
- For Arterial or hemodynamically unstable patients, consider embolization
• In curative setting, prioritize optimal oncologic management