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Objective:The incidence of brain metastasis from esophageal cancer(BMEC)has increased in recent years.Thus,it is necessary to identify factors that affect long-term outcomes for such patients.Methods:From January 1997 to July 2018,consecutive patients(10,043 patients,31 with brain metastasis)with esophageal cancer(EC)treated at Zhejiang Cancer Hospital were recruited for retrospective analysis.Demographic,clinical,and pathological variables and the survival data were retrieved.Results:The median time from diagnosis of EC to diagnosis of brain metastases was 7.67(range,0.43-55.20)months.The median survival time of BMEC patients from diagnosis of primary esophageal tumor was 16.7(range,2.33-163.30)months and the median survival time from the point of diagnosis of brain metastasis was 6.47(range,0.43-148.13)months.Univariate and multivariate analyses showed that the pathology type,EC without chemotherapy,and bone metastasis history were significantly associated with a shorter time interval between the first treatment of EC and brain metastasis.Chemotherapy history after brain metastasis,whole brain radiation therapy(WBRT)history,and surgery were significant predictors for better long-term survival outcomes.Conclusions:Our findings indicate that the use of surgery,WBRT,and chemotherapy can achieve the best therapeutic effects for BMEC patients.