Objective: To study the biocharacteristics of primary esophageal adenocarcinoma (PEAC) and factors influencing patients’ prognosis and to find rational surgical indications and combined therapy. Methods: To analyze the clinical material of 106 patients with PEAC and compared with that of patients with esophageal squamous-cell carcinoma (ESCC). Results: The overall resectability, morbidity and 30-day mortality rates of PEAC were 92.5%, 23.5% and 2.8% respectively,similar to those of ESCC. The TNM staging, lymph node metastasis, extraesophageal invasion and the nature of operation were major determinants influencing longterm prognosis. The 5-year survival rate of PEAC was 21.0%, which was lower than that of ESCC (P＜0.01).Metastasis or recurrence remained to be the cause of death in 82.4% of patients who lived longer than 5 years,which was higher than that of ESCC (P＜0.01). Adjuvant radiation did not influence survival of the patients with lymph node metastasis, but appeared helpful to the patients with no lymph node metastasis. Conclusion:compared with ESCC, PEAC is a malignant disease with poor prognosis. Surgical resection is the first and chief choice of treatment, Surgical indications include patients in stage 0, Ⅰ, Ⅱ and some in stage Ⅲ and even in stage Ⅳ of PEAC. Early detection, early diagnosis and early treatment as well as radical operation could improve prognosis. Adjuvant radiotherapy appears helpful only to the patients without lymph node metastasis.