Regenerative medicine for esophageal reconstruction after cancer treatment

We read with interest a review of the esophageal reconstruction reported by Kerm and colleagues [1], and would like to add some information pertaining to the various therapies covering endosurgical defects. The authors pointed out that few patients were included in the clinical trials and a more extensive clinical study is needed to establish the efficacy. They further state that fullthickness tissue replacement after esophagectomy remains a challenge. Advances in stem cell and cell-sheet technologies could provide the ultimate solution to complications after esophagectomy, e.g. postsurgical strictures and stenoses. We agree. As mentioned in their fine review, we published a pilot study in ten patients with autologous oral mucosal cells cultivated on membranes (cell sheet) [1]. In the meantime, we have performed additional prospective clinical studies in Sweden as well as in Japanwhere 30 patients after ESD or RFA (Barrett's esophagus) were treated [2]. The favorable outcomes of these studies will be published soon (manuscripts in preparation) and a randomized clinical trial is planned. These clinical studies, by virtue of in vitro experiments demonstrating the activation of stem cells and using confocal laser microscopy to monitor the healing of these cell sheets, underscore the feasibility and rationale of such an approach [3]. I declare that Masayuki Yamato is a shareholder of CellSeed Inc. References