Characteristics of brain metastases from esophageal carcinoma.

Takahiro Yamamoto,Naoki Shinojima,Hideo Nakamura,Jun-Ichiro Kuroda,Shigetoshi Yano,Toru Nishi,Tatsuya Takezaki,Keishi Makino,Jun-Ichi Kuratsu,Takuichiro Hide

doi:10.4103/2152-7806.141468

Takahiro Yamamoto, Naoki Shinojima + Show 8 more

Open Access

https://doi.org/10.4103/2152-7806.141468

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Abstract

Background:Esophageal carcinoma (EC) is a major malignancy with a poor prognosis. Although esophageal cancers rarely metastasize to the brain, the number of patients diagnosed with brain metastases (BM) from EC is steadily increasing. Therefore, the risk factors for BM from EC should be known. Here we reviewed our experiences and the previous literature regarding BM from EC.Methods:Between 2000 and 2013, we retrospectively reviewed the clinical features and neurological findings of 19 patients diagnosed with and treated for BM from EC to determine the clinical risk factors and features.Results:In all patients, the lesions were partially or completed located in the thoracic esophagus, and the average size of the EC lesion at diagnosis was 5.8 ± 2.9 cm, which was smaller than the previously reported size of EC lesions accompanied by BM. Patients without lung metastases were more common than those with lung metastases. The lesions in the 13 patients included squamous cell carcinoma (SqCC) in 9 (69.2%) and small cell carcinoma (SmCC) in 3 (23.0%). Six patients were not examined. Although there was no trend toward a higher incidence of BM in patients with adenocarcinoma and SqCC, this trend was observed in patients with SmCC. Excluding a single patient with SmCC, all patients had beyond stage III disease at EC diagnosis.Conclusions:Our study suggests that BM can occur in patients with EC lesions smaller than those previously reported; moreover, SmCC may be a risk factor for BM from EC.

Highlights

Esophageal carcinoma (EC) is a major malignancy with a poor prognosis
According to the comprehensive registry of EC in Japan, EC often develops in the 7th decade in males, with a male‐to‐female ratio of approximately 7:1.[11]. EC frequently metastasizes to the lymph nodes, liver, lung, and bone, but Surgical Neurology International 2014,5:137 rarely to the brain; the incidence of brain metastases (BM) from EC is approximately 0.6-1.5%.[11,16,22,23]
The number of patients diagnosed with BM from EC is increasing, probably because of advances in diagnostic imaging and treatment of the primary EC lesion.[18,21]

Summary

Methods

Between 2000 and 2013, we retrospectively reviewed the clinical features and neurological findings of 19 patients diagnosed with and treated for BM from EC to determine the clinical risk factors and features. Between 2000 and 2013, 19 patients with BM from EC were diagnosed and treated at Kumamoto University Hospital and Saiseikai Kumamoto Hospital in Kumamoto City in southern Japan. To determine the clinical risk factors and features of BM in patients with EC, we retrospectively reviewed their clinical features and neurological findings. The following information was collected: Patient age and sex, time from EC diagnosis to BM occurrence, EC size, EC stage at diagnosis, treatment, EC location, BM location and imaging characteristics, neurological Syudy Year Patients with BM Appelqvist Anderson and Lad. Sons and Borchard Smith and Miller Present study. Statistical analysis was performed using StatMate III, Version 3.19 (ATMS, Tokyo, Japan)

Results

Discussion

Conclusion