ENDOSCOPIC TREATMENT FOR INOPERABLE CANCER OF THE ESOPHAGUS

Abstract

Our results of endoscopic treatment for advanced esophageal cancer and its usefulness were reported. Endoscopic therapies using a dilator, YAG-laser and prosthesis were performed in 16 patients with unresectable cancer of the esophagus. All patients were male and ranged from 60 to 70 with a mean age of 67.7 years. The major reasons for being inoperable were advanced stage of disease itself, old age, and distant metastasis to other organs. Some patients received previous radiotherapy and/or chemotherapy. Tumor length was 3 to 15cm in size, with a mean size of 8cm. Seven patients had a tracheoesophageal fistula. A mean survival rate after the initial endoscopic treatment was 7.1 months (ranged from 1 week to 38 months). Most patients died from respiratory failure. The performance status was improved in half of the patients. Four patients were able to be discharged from hospital, and 6 patients were free from intravenous hyper-alimentation. All patient except one could swallow soft meals and liquids after endoscopic treatment. These results suggest that endoscopic therapy is extremely effective from the point of improving the quality of life in patients with unresectable cancer of the esophagus. Importance of endoscopic treatment in patients with advanced esophageal cancer complaining of dysphagea should be emphasized although radiation or chemotherapy has been the treatment of choice. We proposed that decision making of indication and selection in use of dilation, prosthesis and laser irradiation should be adequately performed based on the degree and length of malignant stenosis and existence of tracheoesophageal fistula.