Yu J, et al. - By analyzing 3,292 cases of stage II-III thoracic esophageal squamous cell carcinoma (TESCC) from the Surveillance, Epidemiology, and End Results (SEER) database, researchers determined the value of radiotherapy in addition to esophagectomy for these cases. They grouped the patients as those receiving pre- or postoperative radiotherapy plus esophagectomy and those receiving only esophagectomy. Multimodality treatments (pre- or postoperative radiotherapy plus surgery) were noted to be more effective than surgery alone (5-year, overall survival [OS]: 17.3% vs 7.9%; cancer-specific survival [CSS]: 51.8% vs 34.9%). For OS, the stage was noted to be the most significant prognostic factor (II vs III, HR, 0.726), whereas the sequence of radiotherapy and surgery had only marginal significance (pre- vs postoperative, HR, 0.875). In stage III disease, preoperative radiotherapy seemed to provide significantly better survival than postoperative radiotherapy (5-year, OS: 13.0% vs 11.0%; CSS: 49.2% vs 31.7%), but not in stage II disease (5-year OS: 23.5% vs 21.0%; CSS: 62.0% vs 53.4%). This indicates preoperative radiotherapy followed by surgery as the optimal treatment strategy in stage III TESCC.