Elimination of esophageal multiple precancerous lesions by chemotherapy: Potential chemoprevention of metachronous multiple cancer development after curative treatment

Yoshiyuki Yukawa, Manabu Muto, Yusuke Amanuma, Yasumasa Ezoe, Yoko Mashimo, Kimiko Hori, Takahiro Horimatsu, Shuko Morita, Shin’Ichi Miyamoto, Sachiko Minamiguchi, Tsutomu Chiba

    Research output: Contribution to journalArticle

    Abstract

    Background Dysplastic squamous epithelium is a precancerous lesion for squamous cell carcinoma. It is often present in the esophagus and head and neck region, and can be visualized as a Lugol-voiding lesion (LVL) by iodine chromoendoscopy. However, effective treatment for such dysplastic epithelia has not yet been developed. Methods Between March 2008 and July 2011, 40 consecutive patients with advanced esophageal squamous cell carcinoma were treated by two cycles of neoadjuvant chemotherapy (NAC) (5-fluorouracil, 800 mg/m2, d 1–5; cisplatin, 80 mg/m2, d 1: q 21 days) at Kyoto University Hospital, and received iodine chromoendoscopy both before and after NAC. Iodine chromoendoscopy findings were divided into 4 groups: group A, absence of LVLs; group B, several (B10/one endoscopic view) small (B5 mm) LVLs; group C, many (C10/one endoscopic view) small (B5 mm) LVLs; group D, numerous irregular-shaped multiform LVLs. Group C and D are defined as multiple LVLs. Endoscopic changes of LVLs before and after NAC were investigated retrospectively. Results Before NAC, 6, 12, 9, and 13 cases were classified in group A, B, C, and D, respectively. All cases in group A before NAC remained in group A after NAC. Multiple LVLs (group C and D) were significantly improved in 17 of 22 patients (77.3 %), while several small LVLs (group B) were improved in only 4 of 12 cases (33.3 %) (p = 0.025 by Fisher’s exact test). Conclusions Multiple dysplastic lesions tended to improve by chemotherapy. In contrast, there was little change in the mucosa with fewer dysplastic lesions after chemotherapy. These data show that chemotherapy has the potential to eliminate precancerous lesions.

    Original languageEnglish (US)
    Pages (from-to)203-209
    Number of pages7
    JournalEsophagus
    Volume9
    Issue number4
    DOIs
    StatePublished - Dec 1 2012

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    Keywords

    • Chemoprevention
    • Esophageal cancer
    • Precancerous conditions

    ASJC Scopus subject areas

    • Gastroenterology

    Cite this

    Yukawa, Y., Muto, M., Amanuma, Y., Ezoe, Y., Mashimo, Y., Hori, K., Horimatsu, T., Morita, S., Miyamoto, SI., Minamiguchi, S., & Chiba, T. (2012). Elimination of esophageal multiple precancerous lesions by chemotherapy: Potential chemoprevention of metachronous multiple cancer development after curative treatment. Esophagus, 9(4), 203-209. https://doi.org/10.1007/s10388-012-0339-3