[Expert consensus on multidisciplinary diagnosis and treatment of small cell carcinoma of the esophagus (2026 edition)].

Small cell carcinoma of the esophagus (SCEC) is a rare and highly aggressive neuroendocrine tumor with poor prognosis. Its clinical manifestations lack specificity, and diagnosis relies on gastroscopic biopsy pathology and immunohistochemistry. The use of ultrasonic gastroscope, enhanced CT or positron emission tomography-computed tomography (PET-CT), and brain MRI is recommended for accurate staging. The American Joint Committee on Cancer-tumor, node, metastasis (AJCC-TNM) staging system and the Veterans Administration Lung Study Group (VALSG) staging systems are adopted to guide the treatment. The treatment emphasizes a multidisciplinary comprehensive mode incorporating chemotherapy, radiotherapy and surgery. For patients with limited-stage disease, chemotherapy combined with local treatment (surgery or radiotherapy) is recommended. For operable patients, radical chemoradiotherapy or perioperative treatment followed by radical surgery is recommended, while patients with inoperable disease should receive radical chemoradiotherapy. For patients with extensive-stage disease, systemic chemotherapy is the mainstay, while etoposide plus platinum as the preferred regimen. If systemic treatment is effective, additional local treatment may be administered for residual lesions. Palliative treatment is recommended for symptomatic metastases. There is currently a lack of high-level evidence-based medical evidence for immunotherapy, and relevant clinical trials are recommended. This consensus aims to promote the standardized diagnosis and treatment of SCEC and to improve patients' quality of life and long-term survival through multidisciplinary collaboration.