This study assesses factors in staging which may define potentially curable esophageal cancer, and reports experience with exfoliative cytology for diagnosis of asymptomatic cases. The extent of neoplasm in 91 esophagectomy specimens is reviewed and compared to two-year survival rates of patients without evident disease. Metastases to lymph nodes, and muscular penetration by the cancer, but not tumor size, cell type differentiation, or location independently and significantly influenced prognosis. A technique for inexpensive brush cytology of the esophagus and preliminary results demonstrating capability of this method to detect asymptomatic esophageal cancer are described. Early diagnosis of esophageal neoplasm before wall penetration and lymph node spread can lead to improved survival rates from surgical treatment.