Convolutional neural networks (CNNs) have become popular in medical image segmentation. The widely used deep CNNs are customized to extract multiple representative features for two-dimensional (2D) data, generally called 2D networks. However, 2D networks are inefficient in extracting three-dimensional (3D) spatial features from volumetric images. Although most 2D segmentation networks can be extended to 3D networks, the naively extended 3D methods are resource-intensive. In this paper, we propose an efficient and accurate network for fully automatic 3D segmentation. Specifically, we designed a 3D multiple-contextual extractor to capture rich global contextual dependencies from different feature levels. Then we leveraged an ROI-estimation strategy to crop the ROI bounding box. Meanwhile, we used a 3D ROI-attention module to improve the accuracy of in-region segmentation in the decoder path. Moreover, we used a hybrid Dice loss function to address the issues of class imbalance and blurry contour in medical images. By incorporating the above strategies, we realized a practical end-to-end 3D medical image segmentation with high efficiency and accuracy. To validate the 3D segmentation performance of our proposed method, we conducted extensive experiments on two datasets and demonstrated favorable results over the state-of-the-art methods.