The survival rate of patients with carcinoma of the esophagus is dismal. Improvement could be achieved only by earlier diagnosis and radical resection techniques to remove the esophagus and its draining lymphatic bed. En bloc esophagectomy and esophagectomy with three-field lymph node dissection are practiced in some centers in North America, Europe, and Japan. Survival rates with these techniques are better than those obtained with standard resection techniques.