原发性食管小细胞癌（PESC）是一种罕见肿瘤，疗效较差，目前尚无标准化治疗方法。我们的目的是探讨限制期PESC的预后因素和可能的最佳治疗方式。我们回顾性检索了1975年至2019年监测、流行病学和最终结果（SEER）数据库中限制期PESC患者的数据。采用Kaplan-Meier法绘制生存曲线，计算生存率，并采用Log-rank检验生存曲线间的差异。通过单变量和多变量 Cox 回归生存分析探讨预后因素；还进行了Cox回归生存分析来分析治疗组之间的死亡风险并比较每个治疗组之间的生存差异。将非单一治疗（ST）组定义为综合治疗（CT）组，并与ST组进行比较。该研究共纳入186例局限期PESC，生存时间存在差异不同群体之间由于年龄、年份、家庭收入中位数和N阶段的差异而存在差异（P<0.001，P=0.041，P=0.002，P=0.001）。手术组的中位总生存期（mOS）（19个月）长于非手术组（11个月）（P=0.01）。化疗组的mOS（16个月）长于非化疗组（4个月）（P<0.001）。放疗组的mOS（16个月）长于非放疗组（8个月）（P<0.001）。单因素分析显示年龄≥80岁（P=0.006）、年份（1997-2007）（P=0.01）、年份（2008-2019）（P=0.01）、N2（P=0.003）、手术（P=0.02） ）、放疗（P<0.001）和化疗（P<0.001）是影响局限期 PESC 患者总生存期（OS）的预后因素。多因素分析显示SEER分期（P=0.02）、年龄（P=0.007）、放疗（P<0.001）、手术（P=0.006）、化疗（P<0.001）是影响有限期患者OS的独立预后因素。 -阶段PESC。非单一治疗组的预后优于单一治疗组。 CT组优于ST组(P<0.001)。手术联合化疗（SC）组mOS最长，死亡风险降低最高，但无统计学差异。SEER分期、年龄、放疗、化疗、手术是局限期患者的独立预后因素； CT优于ST； SC组的中位生存期最长，但没有统计学差异。2024转化癌症研究。版权所有。

Primary esophageal small-cell carcinoma (PESC) is a rare tumor with poor efficacy, and there is currently no standardized treatment method. Our aim is to explore the prognostic factors and possible optimal treatment modalities for limited-stage PESC.We retrospectively searched the Surveillance, Epidemiology, and End Results (SEER) database from 1975 to 2019 for data of patients with limited-stage PESC. Kaplan-Meier method was used to plot survival curves, calculate survival rates, and Log-rank was used to test the differences among survival curves. Prognostic factors were explored through univariate and multivariate Cox regression survival analyses; Cox regression survival analysis was also conducted to analyze the risk of death among treatment groups and compare the survival differences among each treatment group. The non-single treatment (ST) group was defined as the comprehensive treatment (CT) group and it was compared against the ST group.A total of 186 cases of limited-stage PESC were included in the study, there were differences in survival time among different groups due to differences in age, year, median household income, and N stage (P<0.001, P=0.041, P=0.002, P=0.001). The median overall survival (mOS) of the surgical group (19 months) was longer than that of the nonsurgical group (11 months) (P=0.01). The mOS of the chemotherapy group (16 months) was longer than that of the non-chemotherapy group (4 months) (P<0.001). The mOS of the radiotherapy group (16 months) was longer than that of the non-radiotherapy group (8 months) (P<0.001). Univariate analysis showed that age ≥80 years (P=0.006), year (1997-2007) (P=0.01), year (2008-2019) (P=0.01), N2 (P=0.003), surgery (P=0.02), radiotherapy (P<0.001), and chemotherapy (P<0.001) were prognostic factors affecting overall survival (OS) in limited-stage PESC patients. Multivariate analysis showed that SEER stage (P=0.02), age (P=0.007), radiotherapy (P<0.001), surgery (P=0.006), and chemotherapy (P<0.001) were independent prognostic factors affecting OS in patients of limited-stage PESC. Prognosis was better in the non-monotherapy group than in each monotherapy group. The CT group is superior to the ST group (P<0.001). The surgery combined with chemotherapy (SC) group had the longest mOS and the highest reduced risk of death, but there was no statistical difference.SEER stage, age, radiotherapy, chemotherapy, and surgery were independent prognostic factors in limited-stage patients; CT outperformed ST; the SC group had the longest median survival, but showed no statistical difference.2024 Translational Cancer Research. All rights reserved.