[Endoscopic treatment of esophageal and gastric cancers]

Since 1978 we have applied various endoscopic procedures to esophageal and gastric malignancies for a palliative or a radical purpose. An outline of our experience was presented herein. Endoscopic Laser irradiation has been given to 61 cases (64 lesions) of early gastric cancers as a radical treatment since 1978. The irradiation was repeated once a week until getting disappearance of cancer cells in biopsy specimens. The Laser irradiation has also been given to 13 cases of advanced gastric cancers since 1978 and 12 cases of advanced esophageal cancers since 1985 for palliative purposes, such as, mass reduction, hemostasis, and removals of stenosis or obstruction. From 1991 the endoscopic mucosal resection (EMR) method has been used to 75 cases (93 lesions) as a radical treatment for gastric adenomas (n = 24) and well-differentiated adenocarcinomas less than 2 cm in size without ulceration (n = 69). The endoscopic Laser irradiation for early gastric cancers showed a survival rate of 62.8% after 5 years. The recurrence was preferentially found in depressed cancers and polypoid cancers of more than 3 cm in size, and often appeared within one year after the treatment. The Laser treatment for advanced gastric and esophageal cancers showed a survival rate of 69% and 33% after 6 months, respectively. In many cases, subjective symptoms like gastric bleeding or dysphasia were markedly improved after the treatment. The complete removal of gastric tumors was obtained at 65% with the conventional strip biopsy method, and at 80% with the double snare polypectomy or EMR using the EVL device.(ABSTRACT TRUNCATED AT 250 WORDS)