Esophageal cancer advanced stage T4a can be divided into T4aN0-1M0, T4aN2M0, T4aNxM1, there is no authoritative data to show how long the patients can live at this time, and the patients can undergo timely surgical treatment, radiotherapy and drug treatment, and the 5-year survival rate is in the range of 15% to 20% or less than 10%. Patients with esophageal cancer stage T4aN0-1M0, T4aN2M0, T4aNxM1 generally refer to esophageal cancer stage ⅢB, ⅣA, which is the middle to late stage of esophageal cancer. If patients choose endoscopic mucosal resection and endoscopic mucosal dissection for treatment in time. Patients choose radiation irradiation treatment before and after surgery, or chemotherapeutic drugs such as irinotecan and paclitaxel under the guidance of doctors. The 5-year survival rate of patients with stage IIIB esophageal cancer who take timely measures for treatment under doctors’ guidance is 15-20%. If patients present with stage IVA esophageal cancer, the 5-year survival rate of patients will be less than 10%. It is suggested that esophageal cancer patients with T4aN0-1M0 stage, T4aN2M0, T4aNxM1 stage need to seek medical treatment in time, and doctors will judge the specific survival time according to the patient’s condition.