The 5-year survival rate of mid-stage esophageal cancer is now about 30% from the domestic situation. However, each case is analyzed on a case-by-case basis. If the lymph node dissection is very extensive, the future survival will be much better. According to the foreign literature, including the centers in China, if thoracic-laparoscopic surgery is performed, and the lymph nodes cleared are wide enough, including the lymph nodes next to the recurrent laryngeal nerve, the lymph nodes around the esophagus and the lymph nodes in the abdominal cavity, the 5-year survival rate can reach more than 50% even though it is a mid-stage cancer. Therefore, it is important to distinguish what kind of surgery is done and whether the intermediate stage is caused by positive lymph nodes or simply an enlarged tumor. If the tumor is large, the lymph node positivity rate is very low and the survival rate is better. Conversely, if the number of positive lymph nodes is very high, the long-term survival rate will be worse, even though the primary tumor in the esophagus is relatively small. In this case, additional adjuvant treatment is needed, so for a mid-stage tumor, it is important to integrate all medical treatments.