The therapy and survival rates of patients with esophageal carcinoma at the Cleveland Clinic over the 12-year period 1969-1980 are reviewed. Data on 238 patients were analyzed. Seventy-one per cent of the patients underwent surgery, with esophagogastrectomy being performed in half of these. One or more early postoperative complications occurred in 72.6% of these patients. Most of these complications were pulmonary and related to the patients' chronic obstructive pulmonary disease. The mortality rate for esophagogastrectomy at the Cleveland Clinic has decreased over the past 15 years to 7.1%. The 5-year survival rate after "curative" esophagogastrectomy was 15.4% with a mean survival time of 34.4 months. Invasion of the tumor through or beyond the serosa in this group of patients was associated with an increased relative risk of death of 3.3 compared to those with lesser degrees of invasion. The cell type, degree of differentiation, stage of disease, and presence of tumor at the lines of resection were all prognostically significant for all patients.