Comparison of local tumor recurrence following excision with the CO₂ laser, Nd:YAG laser, and argon beam coagulator

Abstract

This study compares the incidence of local tumor recurrence following primary excision with the CO2 laser, Nd:YAG laser (contact), Argon Beam Coagulator, or electrocautery. One hundred eight Fisher 344 rats with R3230AC mammary tumors (1.6 +/- 0.04 [SD] cm diameter) were used. All animals were randomized into groups of similar tumor size. In groups C and CS, excision was performed with a Sharplan 1060 CO2 laser (TEMoo, 25 W, continuous wave [CW], 0.2-mm spot size). Wounds in group CS were "sterilized" (0.5-mm spot size, 25 W, CW) by gently heating the wound without causing blanching or charring. In group N, a 0.4-mm contact Laser Blade and a Cooper 8000 Nd:YAG laser at 20 W CW was used. In groups SA1 and SA2, tumors were excised with the scalpel, and hemostasis and wound "sterilization" were accomplished with the Bard System 6000 Argon Beam Coagulator (ABC) at 40 W and 4 liters/min argon gas flow in SA1 and 12 liters/min in SA2. In group E, excision was accomplished at 40 W blend mode, 10 W spray mode. In group EA, excision was accomplished at 60 W cutting current, and hemostasis was achieved with the ABC. The animals were examined for evidence of recurrence for 34 days postoperatively. Mortalities were excluded from analysis. The incidence of recurrence was 11/14 (79%) in C, 6/16 (38%) in CS, 10/14 (71%) in SA1, 6/13 (46%) in SA2, 6/15 (40%) in N, 7/10 (70%) in EA, and 3/15 (20%) in E. Group E is statistically different (P less than .01) from groups EA, C, and SA1. Group C was different (P less than .01) from groups E, CS, and N. These results demonstrate an inverse relationship between tumor recurrence and local thermal effects at the surgical site. The ABC did not increase tumor recurrence. Contact YAG surgery was similar to CO2 laser excision and "sterilization." An attempt to study the influence of gas flow and pressure on local tumor recurrence and metastases should be made.

Detection and minimally invasive treatment of early squamous lung cancer

“…This produces a plasma jet that transfers the energy homogeneously to the tissue. The coagulative necrosis after standard electrocautery and APC are similar [Go et al 1991;Lanzafame et al 1988;Rusch et al 1990;Sessler et al 1995]. APC is a very safe method because it causes very superficial tissue destruction, but is therefore less efficient in the case of bulky tumor.…”

“…The coagulative necrosis after standard electrocautery and APC are similar [Go et al . 1991; Lanzafame et al . 1988; Rusch et al .…”

Applications of laser technology in breast cancer therapy

“…Histologic evaluation of surgical wounds documented the presence of residual tumor implants in all wounds. The cytoreductive effects of laser sterilization or laser hyperthermia were demonstrated [1,33]. The effect of surgery on a second tumor challenge was investigated by observing the growth of R3230AC tumor implants placed in animals that had undergone excision of the primary tumor 14 days previously [34].…”