Cell DNA content was microspectrophotometrically determined in tissues of advanced esophageal carcinoma of 50 Chinese and 82 Japanese subjects. DNA distribution patterns were classified into Types I, II, III, and IV, according to the degree of dispersion and the peak value on the DNA histogram. The proportions of high ploidy (Types III and IV) in Chinese and Japanese patients were 68% and 81.7%, respectively. Overall 5-year survival rates of the Chinese and Japanese were 25.3% and 19.8%, respectively. Five-year survival rates of patients with Types II, III and IV were 45.7%, 23.8% and 0% in Chinese patients and 57.1%, 16.1%, and 0% in Japanese patients, respectively. Thus, differences in nationality were not related to the prognosis. The incidences of high ploidy group in those with an advanced esophageal carcinoma were high and were associated with a poor prognosis in both races. DNA distribution pattern of esophageal carcinoma reflected the outcome and malignant potential in the Chinese and the Japanese.