Objective — to analyze the own results of surgical treatment in patients with locally advanced and metastatic esophageal cancer (EC). Subject and methods. A total of 146 patients with Stage IIB—IVA locally advanced and Stage IVB metastatic EC were operated on in 2009 to 2017. Lower, middle, and upper thoracic esophageal tumors were diagnosed in 52 (36%), 76 (52%), and 18 (12%) patients, respectively. In accordance with TNM 8th edition, Stages II, III, and IV EC were diagnosed in 17 (12%), 67 (46%), and 62 (42%) patients, respectively. Results. Thirty-three (23%) patients received neoadjuvant therapy. The esophagus was extirpated transhiatally in 34 (23%) patients with Stages II and III EC and transthorically in 104 (71%); at the same time 46 (45%) of them had a Stage IV tumor. Also starting in 2014, the clinic performed 8 minimally invasive operations: 4 patients underwent thoraco-laparoscopic esophageal extirpation and 4 more had synchronous thoraco-laparoscopic esophageal one with single-stage plasty of the esophagus with a gastric tube. A fatal outcome occurred in 5 (0.03%) patients. The median survival was 36±4.6 months; the five-year survival rates did not exceed 17%. Conclusion. The combined therapy of patients with locally advanced and metastatic EC should be started with surgery, including endovideo-assisted surgical technologies. This can reduce the preoperative period and the risk of fatal complications of the underlying disease.