Risk factors which determine the long term outcome of Neodymium-YAG laser palliation of colorectal carcinoma.

We have analysed the long term results of YAG laser palliation for incurable colorectal carcinoma in 88 patients. Although initial palliation was achieved in 82%, good palliation could only be maintained in 51% and 41% of patients surviving 6 months and 12 months respectively. The relative inefficacy of YAG laser therapy for palliation of rectal cancer is due to the failure to control extraluminal tumour growth, complications of YAG laser therapy and the poor general condition of these elderly patients. Factors influencing the efficacy of palliation, besides life expectancy, included T classification, and length of the neoplastic stricture. Treatment-related mortality due to perforation was 2.3%. YAG laser therapy, applied as the sole therapeutic modality, is effective for short term palliation of incurable colorectal carcinoma, but is not adequate for long term palliation in most patients. Trials should be conducted to study the effect of combined treatment (e.g. laser + radiotherapy) on palliation.