Clinical features and prognostic factors of brain metastasis from esophageal carcinoma

Background: Brain metastasis from esophageal carcinoma is uncommon. The aims of this study were to assess the frequency of brain metastasis from esophageal carcinoma, describe treatment modalities and their outcomes, and determine predictors of survival. Methods: Between 2004 and 2012, 680 patients with esophageal carcinoma were registered at Keio University Hospital, Tokyo, Japan. Of these patients, 16 (2.3 %) were diagnosed with brain metastasis. We reviewed their medical records and performed statistical analyses. Results: The median survival after diagnosis of brain metastasis was 5.0 months (95 % CI 1.2-8.7 months). The only statistically significant baseline characteristic that predicted worse survival from brain metastasis was the onset form of brain metastasis (p = 0.01). At the onset of brain metastasis, the median survival from brain metastasis was 13.0 months (95 % CI 0.0-31.0 months) in patients without extracranial metastasis and 2.0 months (95 % CI 0.0-4.3 months) in patients with extracranial metastasis (p = 0.01). Conclusions: Approximately 2 % patients with esophageal carcinoma were diagnosed with brain metastasis. The prognosis of brain metastasis is extremely poor, but long-term survival may be expected with intensive treatment for brain metastasis when the first metastatic site is the brain.