Palliation of malignant esophageal Dysphagia: would you like plastic or metal?

Advanced esophageal carcinoma has a rather dismal prognosis with dysphagia to solids and liquids as a common symptom. Self-expanding metal stents provide immediate and durable relief of dysphagia. Recently, self-expanding plastic stents have been developed for refractory benign esophageal strictures but may have applications in malignant strictures as well. In this issue of The American Journal of Gastroenterology, a multicenter, prospective, randomized, comparative trial evaluates the safety and efficacy of self-expanding metal versus plastic stents for palliation of dysphagia due to esophageal cancer. While the stents compared equivalently for symptom relief, complications were observed more commonly in the plastic stent group.