Palliation of non-resectable carcinoma of the cardia and oesophagus by argon beam coagulation.
BACKGROUND
The aim of this study was to describe the argon beam coagulation (ABC) technique in the palliative treatment of patients with nonresectable carcinoma of the cardia and oesophagus and this treatments needs, complications and tolerance.


METHODS
A retrospective evaluation of 31 patients referred for palliation by ABC over a period of nearly four years (1.1.98-31.8.01).


RESULTS
Twenty-two men and nine women, median age 72 years (range 49-91 years), underwent a total of 163 treatments and a median of five treatments per patient (range 1-18). Recanalisation enabling passage of the scope was achieved in 89% of treatments, and most of these patients had dysphagia grade = 2. The median range between reinterventions was 25 days (range 1-175 days). Perforation was seen in three patients and in 1.8% of treatments; procedure related mortality was 1.2%. The median hospital stay for every treatment was two days (range 1-27 days) and the median inpatient stay as a proportion of survival time was 8%. The median survival was 190 days (range 7-612 days) with the 1-year survival 19%.


CONCLUSIONS
ABC is a well-tolerated, safe and effective treatment in patients with non-resectable cancer of the oesophagus or cardia and offers an acceptable complication rate and number of reinterventions compared with laser and stent placement. The technique is easy and cheap, and requires no further restrictions than conventional monopolar electro coagulation does. Prospective randomised trials comparing the efficacy of the different palliative treatments for patients with oesophagogastric cancer are needed.
Eriksen
Jens Ravn
JR
jravn@dadlnet.dk
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols; D001128:Argon / Q000627:therapeutic use*; D001803:Blood Transfusion; D002277:Carcinoma / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D002404:Catheterization; D003718:Denmark / Q000453:epidemiology; D004724:Endoscopy; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D004939:Esophageal Perforation / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006338:Heart Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D006801:Humans; D017075:Laser Coagulation; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010343:Patient Admission; D011868:Radioisotopes / Q000627:therapeutic use*; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D011868:Radioisotopes; D001128:Argon