Endoscopic and surgical palliation of gastrointestinal tumors

Approximately 40-50% of patients with gastrointestinal tumors are not candidates for curative surgery because of locally advanced tumors or metastatic disease. In the course of the disease most of these patients will require palliative treatment because of obstruction, fistula, pain or hemorrhage. Various endoscopic and surgical procedures can be offered to these patients to alleviate the symptoms of the disease, to improve quality of life and to increase their survival time. However, the potential risk of each treatment must be balanced carefully with the expected benefits and the prognosis of the individual patient. Consequently, minimally invasive procedures, i.e. endoscopic and laparoscopic procedures, have been increasingly used for palliation in recent years. This article provides an overview on endoscopic and surgical palliation of gastrointestinal tumors on the basis of our own experience and a review of the literature.