Palliative treatment of rectosigmoid carcinoma by laser endoscopic photoablation.

Ninety-five patients underwent endoscopic outpatient neodymium:yttrium aluminum garnet or argon laser treatments for palliation (relief of obstruction, control of bleeding or discharge) of rectosigmoid carcinoma at the Lille Multidisciplinary Laser Center. All patients were classified as inoperable because of coincident medical conditions or extent of tumor. Two groups were identified as follows: 10 group 1 patients had exophytic tumors less than 3 cm in diameter, and 85 group 2 patients had more advanced tumors. Local control of the tumor was obtained in all patients in group 1 without complication. Eighty-five percent of group 2 patients were symptomatically improved by the treatment. The survival rate (by life table analysis method) at 24 mo was only 19%, but the percentage of surviving patients who remained symptomatically improved was high [90% (3 mo) to 68% (24 mo)]. Factors influencing improvement or survival rates include the main symptom at the beginning of treatment, reason for choosing laser treatment, and circumferential extent of tumor base. There was one fatal perforation and one perirectal abscess. Laser photoablation was able to locally control small rectosigmoid carcinomas in patients unable to undergo incisional surgery. Laser treatment provided relief of symptoms in inoperable patients with advanced rectosigmoid carcinomas.