PS02.130: BRAIN METASTASIS IN ESOPHAGEAL CANCER: SINGLE CENTER EXPERIENCE

Abstract

Abstract Background Multimodal therapy is the treatment of choice in patients with esophageal cancer. This therapeutic strategy has led to an improvement in disease related survival. Despite the pathological response to therapy, the recurrence rate is not negligible. Brain localization is not an elective site of metastasis of the esophageal tumors but with the new chemoradiotherapy strategies it seems to evidence an increase in incidence in the different series. Objectives of the current study is to assess brain metastases frequency, therapeutic strategy and survival. Methods This is a single centre observational retrospective study: from 2006 to 2017, at Upper G.I. Surgery Division of Verona University, 327 patients (144 squamous cell carcinoma-SCC and 183 adenocarcinoma-ADK) with locally esophageal SCC or ADK have been operated. Nineteen patients (6%) with brain metastases were identified and classified as sinchronous (< 6 months after surgery) and metachronous (> 6 months) We evaluated the timing of metastasis occurrence, the features of the primary tumour, the therapy adopted, the distribution of metastases and survival. Results Of the nineteen metastatic patients, five were SCC and 14 were ADK patients. Ten patients presented synchronous metastasis and 9 metachronous. Eleven had a single metastasis, whilst 8 presented multiple lesions. Metastases were mostly sovratentorial. 7 patients were treated with surgery + stereotactic radiosurgery (SRS), 4 with surgery + whole brain radiotherapy (WBRT), 5 with only WBRT, 2 with only SRS and 1 case was treated with palliative care. Median overall survival of the brain metastasis group was 25 months, significantly lower than non metastatic patients (132 months), local metastasis (34 months) and other distant metastasis (29 months). Conclusion Brain metastasis from oesophageal or oesophago-gastric junction represent a minority of the patients and present a poor prognosis. Despite that, an aggressive treatment for limited lesions can lead to a prolonged overall survival and should therefore be evaluated in specialised centres. Disclosure All authors have declared no conflicts of interest.