Very few studies have attempted to correlate long-term postesophagectomy survival with hospital case volumes. Rouvelas and colleagues take advantage of an unusual in-patient cancer registry, initiated in Sweden in 1987, that provided medical data for a cohort of 1199 patients with esophageal cancer operated on during a 14-year interval. High-volume hospitals performed 10 or more esophagectomies per year. There were 2 HVHs and 51 LVHs. Patient demographics, tumor stage, and tumor histology were closely matched for the 2 groups.