Endoscopic Nd:YAG laser therapy in patients with early superficial carcinoma of the esophagus and the gastric cardia.

A group of 33 patients, 27 with early superficial esophageal cancer and six with early superficial carcinoma of the gastric cardia, were treated with endoscopic neodymium:yttrium aluminum garnet (Nd:YAG) laser from April 1989 to March 1993. Of the 33 patients, in 32 (97%) the disappearance of the cancer cells was noted. They were treated 1-6 times (average 2.6) with laser irradiation. No serious complications, such as perforation, occurred in the series. Twenty-two patients were followed up for 24-55 months. A negative biopsy was recorded in 16 (72.7%) of the 22 patients; the other six (27.3%) cases were found to have recurrent early cancer during the follow-up period from the 36th to the 40th months, and were treated with supplementary endoscopic therapy or surgical resection. It is suggested that endoscopic Nd: YAG laser may be a safe and effective therapy for early carcinoma of the esophagus and the gastric cardia, when the risks of surgery are too high or the patient has refused surgical resection.