Small cell esophageal carcinoma (SCEC) is one of the deadliest neuroendocrine malignancies, which accounts for 0.4% to 2.8% of all esophageal cancers and often occurs in the middle and lower esophagus1-4 . Due to the feature of rapid progression and high metastasis propensity, the prognosis is dismal, with a 5-year survival of ~10% for limited stage and practically zero for extensive stage5-8 . Due to its rarity, it is not feasible to perform prospective randomized controlled trials (RCTs) on SCEC. No consensus on standardized treatment for SCEC has been reached at present. Currently, the vast majority of patients with limited-stage SCECs (LS-SCECs) are treated with definitive radiotherapy (RT) in Europe and U.S.3,4,6,9-11. The significant predisposition of RT in Western countries makes the direct comparison of RT and surgery difficult to perform by using local cancer registry system, such as The Surveillance, Epidemiology, and End Results (SEER) database. The purpose of this multicenter, retrospective study (ChiSCER) was to investigate the most optimal local treatment, outcomes, and risk factors impacting on survival endpoints in patients with LS-SCEC.