Multivariate analysis (Table 2) revealed that serum albumin [HR 0.658 (0.470–0.923); p = 0.023], sarcopenia [HR 1.638 (1.113–2.410); p = 0.016], TNM stage [HR 2.439 (1.710–3.228); p < 0.0001], and N stage [HR 0.483 (0.262–0.890); p < 0.0001] were independent prognostic factors for OS in ESCC patients. The gene discussed is ALB; the disease is esophageal squamous cell carcinoma.