Out of 100 patients with oesophageal carcinoma, 39 will have the tumour resected, 26 will survive the operation, and only 4 will be alive after 5 years. Although surgical resection is the best treatment for squamous cell carcinoma, new trends in pre-operative chemotherapy should provide better results. A therapeutic regimen based on data from the literature and on personal experience is suggested as neoadjuvant chemotherapy in operable and in nonsurgical tumours. Operability should be re-evaluated after 2 courses of chemotherapy according to response rate. Surgical possibilities and post-operative treatment depend on this response. Surgical procedures and the indications of surgery are described.