We studied a series of 150 patients treated for thoracic esophageal carcinoma at our institution. The patients were divided into two matched groups. Group B underwent transthoracic esophagectomy with mediastinal and abdominal lymphadenectomy only; group A also underwent bilateral neck lymph node dissection. The rates of operative mortality and operative complications did not differ significantly between the two groups. The 5-year survival rate was 38.7% overall (48.7% in group A and 33.7% in group B). Group A had a significantly better survival curve than group B. Twenty patients (26.0%) in group A had metastasis in the dissected neck lymph nodes. The 4-year survival rate of these patients was 47.9%. The significantly better survival of group A and the satisfactory prognosis in the patients with positive cervical lymph nodes demonstrates the effectiveness of neck lymph node dissection in radical operation for thoracic esophageal carcinoma.