The diagnosis of esophageal cancer continues to stimulate much research to find the most effective methods of treatment. Combined radiotherapy and chemotherapy may produce results as good as if not better than those with operation plus radiotherapy and chemotherapy. Esophagogastrectomy is performed using any one of several surgical approaches. The individual status of the patient is an important determinant when selecting the surgical approach. There is no clear evidence that one approach is superior to another. Patients should be evaluated appropriately and prepared for operation so that they have the best chance for having a benign postoperative course. Postoperative nursing management requires complex assessment and intervention skills. The optimal approach to the management of esophageal cancer has yet to be defined. Esophagogastrectomy remains primarily a palliative, not curative, approach to patient management. The prevention of postoperative complications through astute assessment and intervention will improve the quality of patient outcomes.