Abstract: Objective To study the changes of five-year survival (FYS) in esophageal squamous cell carcinoma (ESCC) after surgical treatment from 1973 to 2005 and to determine the key risk factors for the survival. Methods Follow-up and questionnaires were performed by interview at home and repeated telephones to the patients and their relatives or doctors.Clinicopathological information was collected based on the hospital medical records.Based on the diagnosed year for ESCC,the patients were classifi ed into three groups by 11 years (group 1: 1973—1983,group 2: 1984—1994 and group 3: 1995—2005). Chi-square test was applied to analyze the distribution of gender,age and clinicopathological characters. Survival was analyzed by Kaplan-Meier or life table.The risk factors was researched by Log rank test and Cox model. Results A total of 3 160(96.7%) ESCC patients were followed up successively. There were 984 (31.1%), 1 101 (34.9%) and 1 075 (34.0%) cases, in group 1, 2 and 3, respectively. The overall FYS rate was increased among 3 groups (8%, 15% and 41%, respectively, P=1.2E-77). It was noteworthy that, the FYS rate in group 2 with Tis+T1 and T2 was similar to group 3. However, the FYS rate in group 3 with T3+T4 was signifi cantly higher than that in group 2 (P=7.0E-7). In addition, the FYS rate of ESCC patients with positive lymph node metastasis was increased signifi cantly (P=1.5E-13). Conclusion The overall FYS rates were dramatically improved recently. The FYS rates of ESCC patients with lymph node metastasis and middle and late stage were increased significantly. Gender, lymph node metastasis, lesion sites and positive stump cancer were independent factors for prognosis of ESCC .