APPLICATION OF LOCOREGIONAL CHEMOTHERAPY USING LYMPHDIRECTED SUBSTANCES IN A CANINE TRANSHIATAL ESOPHAGECTOMY MODEL

Abstract

We investigated whether lymph-directed substances injected into the mediastinal connectivetissue of dogs reached the regional lymph nodes of the esophagus. In 46 dogs, 1.5 mL ofcuttlefish particles or activated carbon particles containing 15 mg of bleomycin (CH-BLM) wasinjected at two sites: into the connective tissue between the trachea and the aorta viamediastinoscopy in 23 dogs (16 with cuttlefish particles and 7 with CH-BLM: mediastinalgroup), and into the crura of the diaphragm by means of laparotomy in 23 dogs (16 withcuttlefish particles and 7 with CH-BLM: crural group). Cuttlefish particles, distinguished bydecolorization with melanin bleaching, showed selective affinity for lymphatics.When cuttlefish particles were injected into mediastinal connective tissue, the rate ofstaining (# of black-stain positive nodes/# of examined nodes) was higher in the crural groupthan in the mediastinal group. In the crural group, bleomycin activity in lymph nodes was higherin the regions from the neck to the abdominal para-aortic region than at the injection site,excluding the peri-gastric region. If the topography of lymphatics and lymph flow kinetics in manare similar to that of the dog, then the crura of the diaphragm appears to be a potentiallyeffective site for applying loco-regional chemotherapy for carcinoma of the esophagus inpatients undergoing transhiatal esophagectomy.