Abstract: Objective :To confirm the long term survival improvement by ⁶⁰Coγ preoperative radiotherapy on middle and late-staged esophageal carcinoma cases. Methods :Life table and Kaplan-Meier survival analysis were adopted for the follow up data, within 16 to 30 years, in the 336 randomly allocated pre-radiotherapied and 1680 simple surgery esophageal cases to compare the survival differences. Results :Significant differences were found in the 5、10 and 15 year survival rates between the two case groups. The preradiotherapied group has a significantly elevated survival curve than the simple surgery group for 1-15 years after operation (P=0.001); significant differences in favor of pre-radiotherapy were found in the subgroups of pre-and post-radiational stage decreased Ⅱ a cases, middle segment esophageal carcinoma, completely resected cases. Conclusions :⁶⁰Coγ Preradiotherapy improves the long term survival of middle and late-staged esophageal carcinoma cases. Pre-radiotherapy should be considered as a routine practice for middle and late-staged esophageal carcinoma cases.