Little is known about the effectiveness of postoperative radiotherapy in patients with lymph node-positive squamous esophageal cancer. For this reason, Dr. Hsu et al. of the Department of Thoracic Surgery at Taipei Veterans General Hospital conducted a retrospective study and found that patients with lymph node-positive esophageal squamous carcinoma who received postoperative radiochemotherapy achieved a greater survival benefit compared with a single surgery. The article was published in the March 6, 2014 issue of Ann Surg. A total of 290 patients with squamous esophageal cancer were included in the study, 104 in the postoperative radiotherapy group and 186 in the single-surgery group. A propensity score matching system was applied to identify 56 pairs of patients. The results showed that in N0-stage patients, there was no significant difference in overall survival and disease-free survival between the two groups. Among lymph node-positive patients, the postoperative radiotherapy group had a median overall survival of 31 months and a 3-year overall survival rate of 45.8%, while the single surgery group had a median overall survival of 16 months and a 3-year overall survival rate of 14.1%. There was a significant difference between the two groups. Similarly, the postoperative radiotherapy group had a median disease-free survival of 16 months and a 3-year disease-free survival rate of 24.1%; the single-surgery group had a median disease-free survival of 9 months and a 3-year disease-free survival rate of 11.5%. There was also a significant difference between the two groups. Among propensity-matched lymph node-positive patients, the median overall survival was 29 months and the 3-year overall survival rate was 48.6% in the postoperative radiotherapy surgery group, and 16 months and the 3-year overall survival rate was 16.8% in the single-surgery group. The postoperative radiotherapy group had a median disease-free survival of 11 months and a 3-year disease-free survival rate of 21.3%; the single-surgery group had a median disease-free survival of 8 months and a 3-year disease-free survival rate of 12.5%. The study suggests that in patients with lymph node-positive esophageal squamous carcinoma, receiving postoperative radiochemotherapy may prolong survival compared with single surgery, resulting in a better survival benefit for patients. For this conclusion, it is worthwhile to expand the sample for further study for clinical promotion.