OBJECTIVES:~Primary~Assess differences from baseline in health-related quality of life of patients with malignant dysphagia due to cancer of the esophagus or gastroesophageal junction palliated with self-expanding plastic stents (SEPS) compared to those who receive self-expanding metal stents (SEMS).~Secondary~Perform a cost-effective analysis of each type of stent by independent evaluation of the rates of SEPS-related and SEMS-related morbidity that necessitates repeat endoscopic interventions and/or additional healthcare costs in these patients.~Analyze effective palliation (degree and duration of improvement of dysphagia) in these patients.~Determine the individual rates of complication associated with each type of esophageal stent in these patients.~OUTLINE: This is a randomized, controlled study. Patients are randomized to 1 of 2 treatment arms.~Arm I: Patients undergo placement of a self-expanding metal stent on day 1.~Arm II: Patients undergo placement of a self-expanding plastic stent on day 1. Health-related quality of life is assessed at baseline, 30 days, and 3 months.~PROJECTED ACCRUAL: A total of 90 patients will be accrued for this study.
RATIONALE: Placing a stent in the esophagus may lessen swallowing difficulties and improve quality of life in patients with malignant dysphagia caused by esophageal cancer or gastroesophageal junction cancer.~PURPOSE: This randomized clinical trial is studying self-expanding plastic stents to see how well they work compared with self-expanding metal stents in treating patients with malignant dysphagia caused by esophageal cancer or gastroesophageal junction cancer.