Esophageal varices obliterated by photodynamic therapy for coexisting early esophageal carcinoma

Ido, Kenichi; Yamamoto, Hironori; Kawamoto, Chiaki; Koiwai, Hirobumi; Yoshida, Yukio; Kimura, Ken

doi:10.1016/s0016-5107(97)70156-1

Cited by 14 publications

(9 citation statements)

References 5 publications

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“…The next problem will be how to treat early esophageal cancer associated with esophageal varices. For the therapy of esophageal cancer associated with esophageal varices, esophagectomy, 4 photodynamic therapy 5 and EMR followed by EIS 6 have been reported.…”

Section: Discussionmentioning

confidence: 99%

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Successful endoscopic therapy of superficial esophageal cancer on varices in a patient with alcoholic liver cirrhosis

Funakoshi¹,

Akiyama²,

Kozakai³

et al. 2001

Digestive Endoscopy

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A case of successful endoscopic therapy of superficial esophageal cancer on varices in a patient with alcoholic liver cirrhosis is reported. A slightly depressed superficial cancer (type 0‐IIc) occupied half the inner surface of the middle esophagus. Endoscopic ultrasonography revealed esophageal varices and periesophageal collaterals, but no perforating veins connecting the varices and collaterals were observed where the cancer was located. The esophageal cancer could not be detected even with a 20 MHz microprobe. The tortuous esophageal varices in the lower esophagus were endoscopically ligated to reduce blood flow just below the cancer and 10 mL polidocanol solution was endoscopically injected to induce sclerosis of the varices. After these procedures, the mucosal cancer was endoscopically resected without any severe complications and residual cancer was eliminated by cauterization using a heater probe. Histopathological examination revealed that poorly differentiated squamous cell carcinoma invaded into the lamina propria mucosae but not into the vessels or the lymphatic system. Three years after treatment, the patient showed no signs of local recurrence of cancer. It is considered that the endoscopic techniques used in this patient constitute a valuable and minimally invasive treatment for superficial esophageal cancer on varices.

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Section: Discussionmentioning

confidence: 99%

“…Heavy drinking is a well‐known cause of esophageal cancer 1–3 and several cases of patients with alcoholic liver cirrhosis associated with superficial esophageal cancer spreading over esophageal varices have been reported 4–6 . Recent advances in chromoscopy have made the early diagnosis of esophageal cancer possible 7–11 .…”

Section: Introductionmentioning

confidence: 99%

Successful endoscopic therapy of superficial esophageal cancer on varices in a patient with alcoholic liver cirrhosis

Funakoshi¹,

Akiyama²,

Kozakai³

et al. 2001

Digestive Endoscopy

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“…86 Ido et al reported using porfimer sodium PDT in a patient with alcoholic liver disease and portal hypertension with Stage 1 esophageal varices and a distal esophageal squamous cell carcinoma that persisted despite external beam radiation. 87 Using a reduced porfimer sodium dose of 1 mg/kg laser light was administered 3 days later to deliver 360 J/cm 2 fiber length to the distal esophagus. After healing of the PDTinduced ulceration, the varices were noted to have regressed.…”

Section: Pdt For Cholangiocarcinomamentioning

confidence: 99%

Uses of Photodynamic Therapy in Premalignant and Malignant Lesions of the Gastrointestinal Tract Beyond the Esophagus

Wolfsen¹

2005

Journal of Clinical Gastroenterology

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Much has recently been written regarding the use of photodynamic therapy for the treatment of esophageal carcinoma and dysplastic Barrett's esophagus. This review, however, describes the clinical experience using photodynamic therapy with various photosensitizer agents for the treatment of diseases in other areas of the gut, especially the pancreaticobiliary tract where European studies have established the role of porfimer sodium photodynamic therapy in the management of patients with cholangiocarcinoma.

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“…Dennoch existiert zur PDT mit Photofrin bei Ösophagusfrühkarzinom und bestehenden Ösophagusvarizen 1. Grades ein Fallbericht, bei dem es zu keiner signifikanten Blutungskomplikation kam und die Ösophagusvarizen sich nach PDT sogar verkleinerten [28]. Eine Studie, die die hämodynamischen und histologischen Veränderungen in Ohrvenen von Kaninchen nach PDT mit Photofrin untersuchte, scheint dieses Ergebnis zu unterstreichen [29].…”

Section: Verlauf Und Therapieunclassified

Endoskopische Mukosaresektion eines Ösophagusfrühkarzinoms bei Leberzirrhose und Ösophagusvarizen

Endlicher¹,

Gelbmann²,

Schlottmann³

et al. 2004

Z Gastroenterol

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Squamous cell carcinomas account for more than 80 % of esophageal malignancies in Germany. Alcohol and tobacco smoke are two of the most important risk factors. In superficial esophageal squamous cell carcinoma, endoscopic mucosal resection (EMR) is a very useful and effective treatment modality. However, in patients with submucosal esophageal cancer, radical esophageal resection is regarded as the gold standard for treatment at present. We report the case of a 71-year-old female patient with alcohol-induced liver cirrhosis with esophageal varices and a - therefore inoperable - early esophageal squamous cell carcinoma. Photodynamic therapy (PDT) using 5-aminolevulinic acid (5-ALA) seemed not to be an effective treatment modality due to its limited penetration depth (< 2 mm) and the liver toxicity of 5-ALA. PDT using Photofrin(R) with a higher penetration depth seemed to be associated with a high risk of bleeding due to the esophageal varices. Furthermore, this sensitizer is associated with a high rate of strictures and a long-lasting skin sensitivity. In contrast, arguments against an endoscopic mucosal resection (EMR) were endosonographically suspected submucosal tumor growth and a high risk of bleeding. Nevertheless, with respect to the lack alternatives we decided to perform an EMR after ligation of esophageal varices. The tumor could be resected in sano without major bleeding complication. Histology demonstrated a carcinoma in situ without submucosal invasion. After 3 months a second EMR was necessary due to recurrence. Meanwhile after a follow-up period of 18 months only low grade intraepithelial neoplasia without macroscopically suspicious lesions was observed.

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Esophageal varices obliterated by photodynamic therapy for coexisting early esophageal carcinoma

Cited by 14 publications

References 5 publications

Successful endoscopic therapy of superficial esophageal cancer on varices in a patient with alcoholic liver cirrhosis

Successful endoscopic therapy of superficial esophageal cancer on varices in a patient with alcoholic liver cirrhosis

Uses of Photodynamic Therapy in Premalignant and Malignant Lesions of the Gastrointestinal Tract Beyond the Esophagus

Endoskopische Mukosaresektion eines Ösophagusfrühkarzinoms bei Leberzirrhose und Ösophagusvarizen

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