Lymph node metastases are common in esophageal cancer and are associated with a poor prognosis. Resection and examination of 15-18 lymph nodes is required for adequate staging of esophageal cancer. Improved survival is associated with involvement of five or fewer nodes or lymph node ratio (LNR) of < 0.10-0.20. More extensive lymph node dissection during esophagectomy offers improved staging but may also provide therapeutic benefit in terms of control of locoregional disease and possibly improved overall survival.