Short-and Long-Term Results of Endoscopic Laser Therapy for Gastric Tumors

The efficacy of endoscopic laser irradiation for gastric tumors was evaluated on 130 patients. The patients consisted of 51 cases with advanced cancer, 30 with early cancer, 33 with adenoma and 16 with hyperplastic polyp. In 14 of 22 patients with advanced cancer complicated by stricture of the cardiac region, palliation of the stricture was successfully obtained by laser therapy. The survival rate of patients who obtained an effective improvement of the stricture was greater than that of the patients without palliation. Moreover, relief of the stricture enabled the patients to aquire a better quality of life. Significant tumor reduction by the laser did not affect the survival rate. As for early cancer, 12 of the 30 patients were cured by laser therapy. Adequate eradication of early cancer was possible in lesions of 10mm or less in diameter, which were confined to the mucosal layer with differentiated type of histology, and were without ulcer. The indication of curative laser irradiation should be restricted to highly selected patients, and careful follow-up study by restricted endoscopic examination is required. Adenomas were eradicated in 29 of 33 patients. However, cancer developed within a few years of the laser therapy in 3 of these, possibly indicating an adverse effect of the laser. Recently in Japan, endoscopic mucosal resection (EMR) has become the preferred treatment for early cancer and adenoma. Laser therapy, however, is useful when EMR is impossible because of the location or size of lesions, and when the lesions remain after EMR