The number of new cases of esophageal cancer in the United States in 2000 likely will exceed the 12,000 annually recorded in previous years. Although two histologic subtypes exist, the incidence of adenocarcinoma of the distal esophagus in the last two decades has been increasing dramatically throughout North America and Europe.1–3 The primary risk factor is chronic heartburn leading to a sequence of esophagitis, Barrett’s esophagus, and ultimately adenocarcinoma. The overall 5-year survival rate is a disappointing 5% to 10%. However, in patients who present early in the course of the disease where the tumor is confined solely to the esophagus, the 5-year survival can be as high as 85%, thus emphasizing the importance of accurate staging at the initial evaluation.4