Chemotherapy May Influence Esophageal Lugol Chromoendoscopy Severity: A Retrospective Cohort Study and Literature Review
ABSTRACT Lugol chromoendoscopy is widely used for screening esophageal squamous cell neoplasms (ESCNs) and evaluating dissection margins during endoscopic submucosal dissection (ESD). However, morphological variations may arise following treatment for synchronous cancers. This study aimed to assess...
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| Format: | Article |
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Wiley
2025-07-01
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| Series: | Kaohsiung Journal of Medical Sciences |
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| Online Access: | https://doi.org/10.1002/kjm2.70020 |
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| author | Wen‐Hung Hsu Chien‐Chieh Lin Hsiang‐Yao Shih Leong‐Perng Chan Hui‐Ching Wang Yi‐Hsun Chen Yu‐Chung Hsu Hui‐Min Hsieh I‐Chen Wu |
| author_facet | Wen‐Hung Hsu Chien‐Chieh Lin Hsiang‐Yao Shih Leong‐Perng Chan Hui‐Ching Wang Yi‐Hsun Chen Yu‐Chung Hsu Hui‐Min Hsieh I‐Chen Wu |
| author_sort | Wen‐Hung Hsu |
| collection | DOAJ |
| description | ABSTRACT Lugol chromoendoscopy is widely used for screening esophageal squamous cell neoplasms (ESCNs) and evaluating dissection margins during endoscopic submucosal dissection (ESD). However, morphological variations may arise following treatment for synchronous cancers. This study aimed to assess the impact of chemotherapy on Lugol chromoendoscopy findings during both screening and ESD. From August 2009 to March 2024, ESCN patients undergoing esophageal ESD were enrolled. Lugol chromoendoscopy findings were analyzed based on four criteria: iodine staining, lesion size, margin assessment, and the pink‐color sign. Findings from screening endoscopy and ESD were compared, and medical records were reviewed for chemotherapy and radiation data. A literature review was also conducted to explore the potential effects of chemotherapy on Lugol chromoendoscopy findings. Among the 162 patients in this ESD cohort, 32 (19.8%) demonstrated notable differences between initial and follow‐up Lugol chromoendoscopy. Among them, 14 (43.8%) had undergone chemotherapy prior to ESD, while 26 received chemotherapy within 2 months before ESD. A significant proportion (53.8%) of chemotherapy‐treated patients exhibited faded chromoendoscopy findings (p < 0.01), despite no esophageal radiation exposure. Literature review findings supported our observation that chemotherapy may reduce Lugol voiding lesions. These findings suggest that chemotherapy influences lesion size and morphology during Lugol chromoendoscopy, underscoring the importance of careful timing and interpretation in these patients. |
| format | Article |
| id | doaj-art-2afeac43e6e3406fadb660164fd534b2 |
| institution | Kabale University |
| issn | 1607-551X 2410-8650 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Kaohsiung Journal of Medical Sciences |
| spelling | doaj-art-2afeac43e6e3406fadb660164fd534b22025-08-20T03:50:07ZengWileyKaohsiung Journal of Medical Sciences1607-551X2410-86502025-07-01417n/an/a10.1002/kjm2.70020Chemotherapy May Influence Esophageal Lugol Chromoendoscopy Severity: A Retrospective Cohort Study and Literature ReviewWen‐Hung Hsu0Chien‐Chieh Lin1Hsiang‐Yao Shih2Leong‐Perng Chan3Hui‐Ching Wang4Yi‐Hsun Chen5Yu‐Chung Hsu6Hui‐Min Hsieh7I‐Chen Wu8Division of Gastroenterology, Department of Internal Medicine Kaohsiung Medical University Hospital Kaohsiung TaiwanDivision of Gastroenterology, Department of Internal Medicine Kaohsiung Medical University Hospital Kaohsiung TaiwanDivision of Gastroenterology, Department of Internal Medicine Kaohsiung Medical University Hospital Kaohsiung TaiwanCollege of Medicine Kaohsiung Medical University Kaohsiung TaiwanCollege of Medicine Kaohsiung Medical University Kaohsiung TaiwanDivision of Gastroenterology, Department of Internal Medicine Kaohsiung Medical University Hospital Kaohsiung TaiwanDepartment of Pathology Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung TaiwanDepartment of Public Health Kaohsiung Medical University Kaohsiung TaiwanDivision of Gastroenterology, Department of Internal Medicine Kaohsiung Medical University Hospital Kaohsiung TaiwanABSTRACT Lugol chromoendoscopy is widely used for screening esophageal squamous cell neoplasms (ESCNs) and evaluating dissection margins during endoscopic submucosal dissection (ESD). However, morphological variations may arise following treatment for synchronous cancers. This study aimed to assess the impact of chemotherapy on Lugol chromoendoscopy findings during both screening and ESD. From August 2009 to March 2024, ESCN patients undergoing esophageal ESD were enrolled. Lugol chromoendoscopy findings were analyzed based on four criteria: iodine staining, lesion size, margin assessment, and the pink‐color sign. Findings from screening endoscopy and ESD were compared, and medical records were reviewed for chemotherapy and radiation data. A literature review was also conducted to explore the potential effects of chemotherapy on Lugol chromoendoscopy findings. Among the 162 patients in this ESD cohort, 32 (19.8%) demonstrated notable differences between initial and follow‐up Lugol chromoendoscopy. Among them, 14 (43.8%) had undergone chemotherapy prior to ESD, while 26 received chemotherapy within 2 months before ESD. A significant proportion (53.8%) of chemotherapy‐treated patients exhibited faded chromoendoscopy findings (p < 0.01), despite no esophageal radiation exposure. Literature review findings supported our observation that chemotherapy may reduce Lugol voiding lesions. These findings suggest that chemotherapy influences lesion size and morphology during Lugol chromoendoscopy, underscoring the importance of careful timing and interpretation in these patients.https://doi.org/10.1002/kjm2.70020chemotherapyendoscopic submucosal dissection (ESD)esophageal squamous cell neoplasm (ESCN)Lugol chromoendoscopy |
| spellingShingle | Wen‐Hung Hsu Chien‐Chieh Lin Hsiang‐Yao Shih Leong‐Perng Chan Hui‐Ching Wang Yi‐Hsun Chen Yu‐Chung Hsu Hui‐Min Hsieh I‐Chen Wu Chemotherapy May Influence Esophageal Lugol Chromoendoscopy Severity: A Retrospective Cohort Study and Literature Review Kaohsiung Journal of Medical Sciences chemotherapy endoscopic submucosal dissection (ESD) esophageal squamous cell neoplasm (ESCN) Lugol chromoendoscopy |
| title | Chemotherapy May Influence Esophageal Lugol Chromoendoscopy Severity: A Retrospective Cohort Study and Literature Review |
| title_full | Chemotherapy May Influence Esophageal Lugol Chromoendoscopy Severity: A Retrospective Cohort Study and Literature Review |
| title_fullStr | Chemotherapy May Influence Esophageal Lugol Chromoendoscopy Severity: A Retrospective Cohort Study and Literature Review |
| title_full_unstemmed | Chemotherapy May Influence Esophageal Lugol Chromoendoscopy Severity: A Retrospective Cohort Study and Literature Review |
| title_short | Chemotherapy May Influence Esophageal Lugol Chromoendoscopy Severity: A Retrospective Cohort Study and Literature Review |
| title_sort | chemotherapy may influence esophageal lugol chromoendoscopy severity a retrospective cohort study and literature review |
| topic | chemotherapy endoscopic submucosal dissection (ESD) esophageal squamous cell neoplasm (ESCN) Lugol chromoendoscopy |
| url | https://doi.org/10.1002/kjm2.70020 |
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