Patients with localized (clinical stages I-III), potentially resectable carcinoma of the esophagus received concurrent chemotherapy (paclitaxel/carboplatin/infusional 5-fluorouracil [5-FU]) and radiation therapy (45 Gy) for 6 weeks. After restaging, patients who remained surgical candidates were randomly assigned to receive either definitive esophageal resection or continued chemoradiation to a definitive radiation therapy dose (64.8 Gy). In this multicenter community-based study, combined-modality therapy was curative in approximately one third of patients with localized esophageal cancer. Both combined-modality approaches evaluated in the study produced similar results; however, a successful randomized trial is required to define optimal treatment.