The extent and number of metastatic lymph nodes in 52 patients with oesophageal carcinoma involving more than one lymph node were analysed to determine the efficacy of lymphadenectomy. The patients were divided into two groups according to the number of metastatic lymph nodes, group A: 1-4 nodes (34 cases) and group B: 5 or more nodes (18 cases). The survival of all patients in group A was statistically better than that of the patients in group B (P = 0.02). In cases where metastatic nodes were restricted to one region, the survival of patients in group A was significantly better than that of patients in group B (P = 0.006). By contrast, in cases where metastatic nodes extended to two or more regions, there was no difference between the groups. The present study suggests that lymphadenectomy is effective only for patients with 1-4 metastatic nodes that are restricted to a single region. Lymphadenectomy is less efficacious in cases with five or more metastatic nodes, even when the nodes are restricted to one region, and is similarly ineffective in cases with metastatic nodes extending to two or more regions, regardless of the number of positive nodes.