The conception that carcinoma of the esophagus is a slow-growing tumor of a low degree of malignancy and with little tendency to metastasize has prevailed in almost all writings on the subject to the present time. A notable exception to this has been made by Souttar,1 who has described esophageal carcinoma as highly malignant.
When one considers that the present mortality rate in carcinoma of the esophagus; is almost 100 per cent, it seems likely that failure to cure the disease has been due to the type of the growth more than to the method of treatment. We believe that the prevailing impression that the disease represents a low degree of malignancy, that metastasis is infrequent, and that early diagnosis and the perfection of surgical technic will result in complete removal of the growth without subsequent recurrence in a reasonable number of cases is erroneous. In support of