Abstract: Objective To further understand the key prognostic factors for esophageal cancer. Methods The questionnaire, home interview and / or telephone were performed for survival follow-up on esophageal cancer patients. The Chi-square test,Kaplan-Meier survival curve, Log rank test and multivariate Cox regression model were applied to assess the survival for the female (n=5 999) and male (n=9 918) esophageal cancer patients from 1973-2011. Results The survival time in female patients was signifi cantly higher than that in male (P=5.8E-25). It was noteworthy that, the rate of lymph node metastasis in male patients was higher than in female patients (P=2.7E-12).Furthermore, the prevalence of T3 and T4 in male patients was higher than that in female patients. In contrast, Tis, T1 and T2 in female patients was more common than that in male patients (P=1.2E-14). Interestingly, a similar degree of tumor differentiation was observed in male and female patients (P=0.66). Based on the TNM staging, the proportion of the patients with early stage in female was increased than that in male (13.9% vs.10.8%, P=3.8E-9).Accordingly, the proportion of middle and advanced stage in male was higher than that in female (86.1% vs.89.2%, P=3.8E-9).Cox regression analysis showed that female gender was protective factor, while with lymph node metastasis and invasion (T) deepening were risk factors for long survival of esophageal cancer. Conclusion The survival in female patients was signifi cantly longer than that in male patients. The rates of lymph node metastasis and invasion (T3, T4) in female were lower than those in male and independent factors for prognosis of esophageal cancer.