Abstract: Objective:To analyze the factors affecting lymph node failure pattern after radiotherapy/chemotherapy in esophageal squamous cell carcinoma without initial clinical metastasis. Methods:A total of 263 patients, who were diagnosed as thoracic esopha -geal carcinoma from January 2002to December 2009, were included in this retrospective study. Factors affecting lymph node failure pattern with general clinical data and tumor local factors were analyzed. Results:Among the 263 esophageal cancer cases,31(11 .8%) had lymph node metastasis after treatment, including18cases of simple lymph node metastasis and13other cases of lymph node metas-tasis with esophageal and other organ metastasis or recurrence. The numbers of cases for lymph node metastasis in the upper, middle, and lower thoracic esophagus were 11 (13.3%),13(10.1%), and7 (13.7%), respectively. Univariate analysis showed that recent cura-tive effect, length of tumor on X-rays, maximum tumor diameter, and tumor volume were the significant factors associated with lymph node metastasis ( χ2=7.597, 9.717, 5.361, and 4.815; P=0.006, 0.002, 0.021, and 0.028). Logistic regression analysis results showed that recent curative effect and length of tumor on X-rays were independent significant factors ( P=0.004 and 0.026). Conclusion:Recent cu -rative effect and length of tumor on X-rays were the significant factors associated with lymph node failure pattern after radiotherapy/ chemotherapy in esophageal squamous cell carcinoma without initial clinical metastasis.