Objective: The purpose of the present study was to define the clinicopathological features and prognosis of esophageal cancer. Methods: Between 2004 and 2009, 128 patients with esophageal cancer were enrolled in a retrospective database and divided into two groups on the basis of number positive lymph nodes with the cutoff as four. Results: The findings for 18 patients (14.0%) Group A were compared with those of 110 patients Group B. In the group A, there were significantly more women (12/6 vs. 54/56, P < 0.001). In both groups, the most frequent histological morphology was squamous cell carcinoma (83% and 75%, respectively), although the percentages were significantly different (P < 0.005). In the group A, lesions were more frequently located in the middle one-third of the esophagus than in the group B (61% vs. 28%, P < 0.001). Group A was more likely to be Stage IIa. Survival rates in group A patients at 5 years after resection were 15.8%, similar to those in group B patients (12.1%, difference not significant). Local lymph node metastases and microscopic residual tumor at the line of resection were also more prevalent in the young patients, but not to a statistically significant degree. Conclusions: These findings suggested that the clinical and pathologic features of carcinomas of the esophagus in young patients do not significantly differ from those in older patients.