Objective — to retrospectively evaluate the efficiency of surgical and combined treatment in patients with thoracic esophageal carcinoma. Subject and methods. The results of treatment were retrospectively assessed in 222 patients with Stage I—III thoracic esophageal carcinoma, who were treated at the Thoracoabdominal Department, P.A. Herzen Moscow Oncology Research Institute, in 2007 to 2017. The patients were divided into 2 groups: 1) 128 patients who received surgical treatment only; 2) 94 patients who had combined treatment. The combined treatment included preoperative radiation therapy with radiomodification (5-FU/cisplatin) or chemoradiotherapy according to the NCCN protocol (paclitaxel/carboplatin), followed by surgery. Results. The overall complication rate was 35%; the postoperative mortality rate was 8%. Grade III—IV therapeutic pathomorphism was established in 60% of the patients in the combined treatment group. Long-term results were traced in 150 (68%) patients. The median survival was 44 and 38 months in Groups 1 and 2, respectively (the difference was insignificant; p=0.34). In Group 1, the three- and five-year survival rates were 60 and 40%, respectively; in Group 2, these were 60 and 33%, respectively. The survival rates in Group 2 were analyzed according to the degree of therapeutic pathomorphism. The median survival was 45 months in the Grade III—IV pathomorphism subgroup versus 21 months in the Grade I—II pathomorphism one. Comparing the survival rates showed that patients with locally advanced esophageal carcinoma (T3 or N+) showed better rates in the combined treatment group with Grade III—IV therapeutic pathomorphism versus the surgical treatment group. The median survival was 45 and 32 months, respectively; the 3- and 5-year survival rates were 78 and 28% versus 47 and 23%, respectively (log rank test, p=0.13). Conclusion. Surgical intervention remains the mainstay treatment option for patients with thoracic esophageal carcinoma, which can achieve long-term survival. Esophageal surgery is accompanied by a high risk of postoperative complications and death. Combined treatment is the standard for care of locally advanced tumors; however, improved survival rates were noted only in Grade III—IV therapeutic pathomorphism.