Pathologic factors and the number of nucleolar organizer region proteins (AgNORs) were evaluated as predictors of postoperative recurrence in distant organs in 92 patients with curatively resected esophageal carcinoma. The rate of distant recurrence was significantly higher in patients with venous invasion (53%; 19 of 36) than in those without invasion (21%; 12 of 56) (p < 0.01) and was also higher in patients with an AgNOR score greater than or equal to 4 (49%; 19 of 39) than in those with an AgNOR score less than 4 (23%; 12 of 53) (p < 0.02). The rate of recurrence was significantly higher in patients with both venous invasion and AgNOR score greater than or equal to 4 (67%; 16 of 24) than in the other patients. These findings indicate that the combination of venous invasion and a high AgNOR score predicts distant postoperative recurrences in patients with curatively resected esophageal carcinoma.