Mitomycin C in the Therapy of Recurrent Esophageal Strictures: Hype or Hope?

Abstract

The short-term results of topical Mitomycin C application for refractory esophageal stricture reported in the literature are very encouraging. Prospective studies are mandatory to determine the optimal time points, dosage, and modalities of treatment before a recommendation can be given.

Endoscopic Management of Anastomotic Esophageal Strictures Secondary to Esophageal Atresia

“…51 The dose of mitomycin C used in these studies is also variable, ranging from 0.004 mg/mL to 1 mg/mL. 52 A systematic review of the literature identified 11 publications using mitomycin C in children. 52 The results of the systematic review demonstrated complete relief of symptoms in 21 children (67.7%), with another 6 (19.4%) who had partial relief, and 4 with (12.9%) no benefit.…”

“…52 A systematic review of the literature identified 11 publications using mitomycin C in children. 52 The results of the systematic review demonstrated complete relief of symptoms in 21 children (67.7%), with another 6 (19.4%) who had partial relief, and 4 with (12.9%) no benefit. There were no direct or indirect adverse effects of mitomycin C reported.…”

“…The mean follow-up time for all of these studies was 22 months (range 6-60 months). 52 It is important to note that most of the literature on mitomycin C involves children with caustic strictures, and therefore results may not be applicable to anastomotic strictures. Even in this systematic review, 61% of the patients had caustic strictures and 22% had anastomotic strictures secondary to EA.…”

“…Even in this systematic review, 61% of the patients had caustic strictures and 22% had anastomotic strictures secondary to EA. 52 A recent prospective study looking at 30 children with caustic strictures compared mitomycin C therapy to dilation therapy alone. Although this study was not blinded and does not appear to be randomized, the mitomycin C group did show a statistically significant improvement in dysphagia score (P 5 .005), and an improvement in the median interval between dilations.…”

Corrosive Injury of the Upper Gastrointestinal Tract: A Review

“…Diverse other agents such as Sucralfate, Heparin, Mitomycin C, epidermal growth factor (EGF), Anti-oxidant treatment (vitamin E, H1 blocker, mast cell stabilizer, methylprednisolone) and caffeic acid phenethyl ester (CAPE) have been shown in animal studies to decrease the incidence of stricture formation but studies in humans are awaited [32][33][34][35][36][37][38].…”