Endoscopic palliation of esophageal and cardial cancer: neodymium-yttrium aluminum garnet laser therapy

The aim of this study was to evaluate the impact of laser palliation on sym ptoms such as dysphagia and bleeding in patients with esophageal and cardia l carcinomas, From November 1992 to October 1997, 174 patients with unresec table esophageal and cardial carcinomas were treated with neodymium-yttrium aluminum garnet laser therapy. The indications for palliative treatment we re advanced tumor in 96 patients and high surgical risk in 78, The tumor in volved the esophagus and cardia in 107 and 67 patients respectively. The me an length of the tumors was 6 cm, Two laser sessions (range 1-4) were neces sary for recanalization. During the follow-up, the average interval between the laser sessions was 2 months. Overall, no early and late complications or hospital mortality occurred. The quality of palliation was excellent or good in 82% of the patients. The mean survival time was 6 months, and morta lity was not related to the procedure. Endoscopic laser therapy in patients with vegetant or hemorrhagic carcinomas may represent the best therapy, wi th acceptable morbidity and mortality rates and satisfactory functional res ults.