ENDOSCOPIC YAG LASER THERAPY AS PALLIATIO N FOR ESOPHAGEAL-CARCINOMA

In our institution, the YAG laser has been used to treat 110 patients with inoperable esophageal carcinoma. Therapy was palliative as patien ts presented metastases (41.8%), advanced systemic disease (22.7%), ex tensive local disease (18.2%) or recurrent carcinoma (10%). The study group included 92 men (mean age 68.4 years) and 18 women (mean age 67. 0 years); 47.3% of the patients had received no previous treatment whi le 52.7% had been treated previously with either radiotherapy, chemoth eray, surgery; stents or dilatation. The majority of lesions were aden ocarcinomas (57.3% ) with squamous cell carcinomas in 37.3%; 66.3% of cancers were located in the distal third of the esophagus. The patient s received a mean of 2,4 laser treatments with 4883 joules per treatme nt on average. The rate of major complications was 2.7% and the rate o f mortality 1.8%. The median survival for the group was 4.5 months. No significant difference was found in the length of survival according to the histology of the tumour (p = 0.35), the presence of metastases (p = 0.24) and the association of other treatment modalities with the laser (p = 0.06). Functional results were considered good to excellent in 82.1% of cases. In conclusion, the YAG laser does not influence ov erall survival of inoperable patients, but this therapy is effective a nd safe and is presently the treatment of choice for these patients.