Endoscopic local injection of early gastric carcinoma with 5-fluorouracil

We treated four patients who had early gastric carcinoma with weekly endoscopic local injections of 5-fluorouracil (5FU). In all four patients the lesions disappeared by endoscopic and biopsy examination within 12-18 weeks of treatment. None of the patients experienced side effects which are usually associated with oral or intravenous administration of 5FU. Two patients eventually underwent surgery. In one, a small focus of carcinoma was identified within the resected stomach; no evidence of carcinoma was found in the other. The remaining two patients have not submitted to surgery and are free of carcinoma by endoscopy for over 1 1/2 years. In this uncontrolled study, endoscopic local injection of 5FU appeared to be effective in treating early gastric carcinoma as assessed by endoscopic and histological criteria. Surgery remains the treatment of choice for early gastric carcinoma. However, further studies of endoscopic injection therapy are needed to determine whether this treatment is appropriate for patients with early gastric carcinoma who are not surgical candidates.