**Core Concept**
Esophageal cancer treatment involves a multidisciplinary approach, combining surgery, radiation therapy, and chemotherapy to improve outcomes. The effectiveness of these treatments varies depending on the type of esophageal cancer, its stage, and the patient's overall health.

**Why the Correct Answer is Right**
Chemotherapy for esophageal cancer is generally considered palliative, aiming to alleviate symptoms and improve quality of life rather than achieving a cure. While chemotherapy can be effective in controlling the growth of tumors and managing symptoms, it is not highly effective in curing esophageal cancer, especially when used as a standalone treatment. The addition of chemotherapy to radiation therapy or surgery may improve outcomes, but chemotherapy alone is not a curative option for most patients.

**Why Each Wrong Option is Incorrect**
**Option A:** This statement is generally accurate, as the 5-year survival rate for esophageal cancer is indeed low, ranging from 20-30% depending on the stage and type of cancer. However, this statement is not the false one in this question.
**Option B:** Primary radiation therapy can be effective for squamous cell carcinomas, especially in early-stage disease. However, the statement comparing its efficacy to that of radical surgery is misleading, as surgery is often the standard of care for localized esophageal cancer.
**Option C:** This statement is accurate, as surgical resection of all gross tumor is indeed feasible in only a subset of patients with esophageal cancer, typically those with early-stage disease and a favorable tumor location.

**Clinical Pearl / High-Yield Fact**
When considering treatment options for esophageal cancer, it's essential to remember that the type of cancer (adenocarcinoma vs. squamous cell carcinoma) and its stage play a significant role in determining the most effective treatment approach.

**✓ Correct Answer:** D. Chemotherapy is highly effective and sometimes curable.