Endoscopic Nd-YAG laser therapy for palliative treatment of colorectal adenocarcinoma: A multivariate prognostic analysis
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The aim of this study was to report long-term results of endoscopic Nd-YAG laser therapy used in the palliative treatment of 95 patients with colorectal adenocarcinoma, to define parameters that could predict the long-term outcome and to define better the indications and limitations of Nd-YAG laser therapy. Ninety-five patients, 56 men, 39 women (mean age 78±12 years) were treated. Sixty-three adenocarcinomas were present in the rectum and 32 in the colon. Normal bowel function was restored in 41 of the 55 patients (75%) after a median of 3 (range 1–14) sessions, rectal bleeding was completely controlled in 40 of the 49 patients (82%) after a median of 2 (range 1–7) sessions and other rectal symptoms (mucus rectal discharge and tenesmus) were completely controlled in 12 of the 25 patients (48%) after a median of 3 (range 1–7) sessions. The cumulative probability of remaining symptomatically improved at 6 and 12 months for the 84 patients, initially symptomatically improved by attack treatment, was 45±6% and 15.5±5%. Four perforations, two rectovaginal fistulae, two symptomatic stenoses and two asymptomatic stenoses occurred. In the stepwise regression analysis (Cox model), among eight variables, two variables had an independent prognostic value. The surgical contraindications unrelated to cancer extentp<0.01) and the importance of intraluminal destruction after attack treatment (p<0.01) were positively correlated with duration of symptomatic improvement.
Key wordsNd-YAG laser therapy Palliative treatment Colorectal adenocarcinoma Multivariate prognostic analysis
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