The patient was a 53 year old male, in whom a 9 cm long filing defect from the middle to the lower thoracic esophagus was ob-served in the esophagogram and the invasion to the aorta was suspected in the CT scan. Downstaging was succeeded by the neoadjuvant chemotherapy with two courses of CDDP and a 5- FU and the concurrent radiotherapy of 50 Gy including the bilateral neck. Four weeks after radiotherapy, transthoracic esophagectomy with gastric pull-up through the antethoracic sub-cutaneous route was carried out successfully. Microscopic examination showed no viable cancer cells in the esophageal primary lesion and Grade 2 effects in the regional lymph nodes.