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

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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 (≤10/one endoscopic view) small (≤5 mm) LVLs; group C, many (≥10/one endoscopic view) small (≤5 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.

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Acknowledgments

This work was supported in part by management expenses grants from the Government to the National Cancer Center (grant number 101106).

Conflict of interest

The authors have no conflict of interest.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan

    Yoshiyuki Yukawa, Manabu Muto, Yusuke Amanuma, Yoko Mashimo, Kimiko Hori, Takahiro Horimatsu, Shuko Morita, Shin’ichi Miyamoto & Tsutomu Chiba

  2. Department of Multidisciplinary Cancer Treatment, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Yasumasa Ezoe

  3. Department of Pathology, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Sachiko Minamiguchi

Authors
  1. Yoshiyuki Yukawa
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  2. Manabu Muto
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  3. Yusuke Amanuma
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  4. Yasumasa Ezoe
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  5. Yoko Mashimo
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  6. Kimiko Hori
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  7. Takahiro Horimatsu
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  8. Shuko Morita
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  9. Shin’ichi Miyamoto
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  10. Sachiko Minamiguchi
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  11. Tsutomu Chiba
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Corresponding author

Correspondence to Manabu Muto.

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Yukawa, Y., Muto, M., Amanuma, Y. et al. Elimination of esophageal multiple precancerous lesions by chemotherapy: potential chemoprevention of metachronous multiple cancer development after curative treatment. Esophagus 9, 203–209 (2012). https://doi.org/10.1007/s10388-012-0339-3

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  • DOI: https://doi.org/10.1007/s10388-012-0339-3

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