Objective: To investigate the clinicopathological factors for thoracic esophageal cancer after radical esophagectomy, and provide the criteria to outline the target volume for adjuvant radiotherapy. Methods: Data from 803 patients with thoracic esophageal cancer who underwent radical esophagectomy between January 2014 and December 2018 were reviewed. The lymph nodes metastases and the clinicopathological factors for esophageal cancer were stratified by univariate and multivariate Cox regression analyses. Results: A total of 6,216 lymph nodes were dissected with an average of 9.5 lymph nodes. The lymph nodes metastases in the upper thoracic esophagus were mainly observed in the supraclavicular and paratracheal regions (P<0.05), metastatic lymph nodes in the middle thoracic esophagus were bidirectional, and those in the lower third of the esophagus mainly metastasized to the regions adjacent to the esophagus, the cardia and the left gastric artery (P< 0.05). For the whole group, the lymph node metastases rate was 32.2％ for upper thoracic esophageal cancers, which was significantly lower than 44.0％ for lower thoracic esophageal cancers (P=0.049) and 44.3％of middle thoracic esophageal cancers (P = 0.030). Multivariate analyses showed that patient performance status, T- stage, tumor length, and distant metastases were factors associated with overall survival, with P< 0.05 for all. Conclusion: Patient performance status, T- stage, tumor length, distant metastases, and operative procedures were the most important factors for overall survival. Therefore, in clinical practice, patients undergoing postoperative prophylactic radiotherapy may be selected according to these factors．
