Brain Metastases from Esophageal Cancer: Clinical Review of 26 Cases

Objective To assess the frequency of brain metastasis in patients with primary esophageal cancer and to describe the clinical characteristics, diagnosis, and prognosis. Methods Of 1612 patients with primary esophageal carcinoma treated at a single institution from 2000–2010, a retrospective analysis of the medical files of 26 consecutive patients with central nervous system involvement was carried out. The clinical history, imaging, and pathologic findings were analyzed. Results Of the 26 patients, 12 initially presented with a single cerebral metastatic lesion, and 14 had multiple brain lesions. There were 4 patients with adenocarcinoma and 22 with squamous cell carcinoma. Treatments were as follows: 5 patients underwent surgery followed by whole-brain radiation, 5 underwent stereotactic radiosurgery, 13 received whole-brain radiation, and 3 received chemotherapy. The median survival was 4.2 months; 1-year survival rate was 5.8%. Conclusions In this retrospective study of 1612 patients with esophageal carcinoma at a single medical center, 1.61% (26 of 1612) of the patients had a diagnosis of brain metastasis. The prognosis is poor for patients with brain metastasis from esophageal carcinoma. A solitary brain lesion, surgical treatment, and a good Karnofsky Performance Status may indicate a good prognosis.