A 20-year experience of treatment of 633 patients with cancer of the thoracic esophagus has been evaluated. Far advanced disease was diagnosed in 384 (60.7%). Radical, palliative and symptomatic surgery was performed in 421 (66.5%), 44. (6.9%) and 168 (26.6%), respectively. No significant differences were reported between the immediate results of radical and palliative treatment. Since survival and quality of life after palliative resection appeared to be better than after symptomatic surgery, the former should be recommended for use in clinic.