This study analyzed 10-year survival rates of 551 esophageal cancer patients who underwent radical surgery. The 10-year survival rate was 45.9%, while factors like early cancer stage, lower N stage, higher ratios of healthy to cancer cells, and adjuvant chemoimmunoradiotherapy significantly improved survival. Neural network analysis revealed that phase transition from N0 to N1-2, ratios of healthy to cancer cells, and early vs invasive cancer stage were the top predictors of 10-year survival.