The 5-year survival rate for esophageal cancer is poor, between 15-30% depending on factors like early detection and treatment quality. Studies show that higher hospital and surgeon volume (more than 20 and 6 esophagectomies per year respectively) are associated with lower mortality rates and better outcomes. A Dutch study concentrated esophageal cancer surgeries across 3 high-volume hospitals and saw improved 2-year survival rates, demonstrating that centralization based on both volume and monitored outcomes can enhance quality. National auditing programs may help further progress.