Brain metastases from esophageal cancer: clinical review of 26 cases

World Neurosurg. 2014 Jan;81(1):131-5. doi: 10.1016/j.wneu.2013.02.058. Epub 2013 Feb 19.

Abstract

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.

Keywords: Brain metastasis; Esophageal carcinoma; Prognostic factor.

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / secondary*
  • Adenocarcinoma / therapy
  • Adult
  • Aged
  • Antineoplastic Agents / therapeutic use
  • Brain Neoplasms / secondary*
  • Brain Neoplasms / therapy
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / secondary*
  • Carcinoma, Squamous Cell / therapy
  • Esophageal Neoplasms / pathology*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Karnofsky Performance Status
  • Male
  • Middle Aged
  • Neurosurgical Procedures
  • Prognosis
  • Radiosurgery
  • Retrospective Studies
  • Survival Analysis

Substances

  • Antineoplastic Agents