OBJECTIVES: The objectives of the study were to assess the quality of life (QOL) among patients with esophageal/cardiac precursor lesion or cancer at different stages, and evaluate changes in QOL during follow-up after primary treatment. METHODS: We enrolled 220 patients with esophageal or cardiac lesion between September 2007 and January 2010. They were followed up with the EuroQol-5 dimension (EQ-5D) for QOL before primary treatment and at 1, 6 and 12 months after primary treatment. We calculated QOL scores (in terms of EQ-5D scores) based on the five-item descriptive system of health states of the EQ-5D and the UK preference weighting system. RESULTS: In total, 74 patients with precancerous lesion, 88 with early stage cancer, and 58 with advanced cancer participated in our survey. Prior to clinical treatment, the average EQ-5D score of patients with advanced cancer was 0.81±0.17 (mean ± standard deviation), significantly lower than that of patients with early stage cancer (0.87±0.09) or precancerous lesion (0.90±0.05) (P<0.01). For precursor lesion, the score declined in the first month (P<0.001), and gradually increased to a higher level at 12 months than before treatment (P=0.023). It showed a similar trend for early cancer (P<0.05), though it was not statistically recovered even at 12 months (0.85±0.15 versus 0.87±0.09, P=0.226). Regarding advanced cancer, the score showed a consistent decline, reached the lowest at 6 month, and finally rebounded to a similar level compared to that before treatment (0.80±0.13 versus 0.81±0.17, P=0.624). CONCLUSIONS: Our results indicate that patients with precursor lesion or early stage esophageal or cardiac cancer have better QOL than do those with advanced cancer. Early detection and treatment improve QOL in the long run, despite QOL compromise in the immediate time. Particular attention and extra care should be given in the early period of treatment for patients.