Long-term outcome of endoscopic semiconductive diode laser irradiation therapy with injection of indocyanine green for early gastric cancer.
OBJECTIVE
Semiconductive laser irradiation has been used to treat early gastric cancer. However, the long-term follow up results have not been reported. The objective of the present study was to assess retrospectively the clinical usefulness of diode laser irradiation for early gastric cancer.


METHODS
The subjects of this study were 13 patients (14 lesions) selected from 125 patients with early gastric cancer who were treated by endoscopy during the period from September 1995 to February 2003. The macroscopic tumor type was superficial type, including eight lesions of 0'-IIc and six lesions of 0'-IIa. Histological diagnoses were eight cases (nine lesions) of well-differentiated adenocarcinoma, three cases of moderately differentiated adenocarcinoma and two cases of poorly differentiated adenocarcinoma. After injection with indocyanine green solution (1 mg/mL) into the submucosal layer, a semiconductive diode laser (30-40 W/s) was irradiated by the non-contacting method.


RESULTS
The total amount of laser irradiation for 14 lesions was 9568.80 +/- 7197.01 J on average. There was no major complication. In the period up to December 2007, six patients survived and seven patients died. However, no-one died of progression of gastric cancer. The mean survival times of all patients, survivors and patients who died were 5 years 2.8 months; 6 years 4.5 months; and 4 years 11.7 months, respectively.


CONCLUSIONS
Early gastric cancer can be successfully treated by laser therapy with few complications and good prognosis. This method is expected to be most suitable and effective for elderly patients with serious underlying disease.
Kawaguchi
Atsushi
A
Department of Diagnostic and Therapeutic Digestive Endoscopy and Department of Internal Medicine, National Defense Medical College, Saitama, Japan. atsushi@ndmc.ac.jp
Nagao
Shigeaki
S
Takebayashi
Koichi
K
Higashiyama
Masaaki
M
Komoto
Shunsuke
S
Hokari
Ryota
R
Miura
Soichiro
S
D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D004396:Coloring Agents; D005260:Female; D005773:Gastroscopy; D006801:Humans; D007208:Indocyanine Green; D007267:Injections; D053685:Laser Therapy; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*
D004396:Coloring Agents; D007208:Indocyanine Green