Clinical and Preclinical Study on Esophageal Cancer-Reconsideration and a View to the Future

Masashi Kodama

First Department of Surgery, Shiga University of Medical Science

In this paper, views of the 21-century are described based on research and clinical experience to cancer of the esophagus. The following problems were presented from a clinical point of view,; (1) Clarify the significance and effects to prognosis of cervical lymph node dissection is a future problem, (2)The combined neo-adjuvant chemotherapy of CDDP/PEP/VDS with pre and postoperative use was not effective to the advanced esophageal cancer. Low dose of CDDP/5FU combined chemotherapy showed a high remission rate. Hereafter, prospective randomized control study should be scheduled for this combined chemotherapy, (3) For the m₃ and sm₁ superficial cancer, it should be clarified whether EMR or operation should be selected. From a research point of view, cyclin D1 was perceived to as the factor that controls a cell cycle, and also uPA and PAI-2 was researched as factors that is related to tumor infiltration and metastasis. As the results, both cyclin D1 and uPA/PAI-2 system were related to the prognosis and may be the important factors that prescribe the malignant potential of esophageal cancer. Furthermore research of comparative genomic hybridization (CGH) has been carried out to screening the gene abnormality. To try developing a new therapy, we have been conducting a basic research with regard to vaccine therapy using cancer specific antigen, to antisense therapy, and to gene introduction therapy that induces apoptosis.

Key words
esophageal cancer, treatment of esophageal cancer, gene abnormality, vaccine therapy for esophageal cancer, gene introduction

Reprint requests
Masashi Kodama First Department of Surgery, Shiga University of Medical Science Seta Tsukinowa-cho, Otsu, 520-2192 JAPAN

Accepted
June 22, 1999

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