To determine the efficacy of postoperative adjuvant chemotherapy with paclitaxel plus cisplatin (Taxol +DDP, TP therapy) for stage IIA esophageal squamous cell carcinoma (ESCC) and to investigate the expressionof RUNX3 in lymph node metastasis-negative esophageal cancer and its relationship with medical prognosis,a retrospective summary of clinical treatment of 143 cases of stage IIA esophageal squamous cell carcinomapatients was made. The patients were divided into two groups, a surgery alone control group (52 patients) and achemotherapy group that received postoperative TP therapy (91 patients). The disease-free and 5 year survivalrates were compared between the groups and a multivariate analysis of prognostic factors was performed.The same analysis was performed for cases classified as RUNX3 positive and negative, with post-operativespecimens assessed by immunohistochemistry. Although the disease-free and 5 year survival rates in controland chemotherapy groups did not significantly differ and there was no significance in RUNX3 negative cases,postoperative adjuvant chemotherapy in the chemotherapy group was shown to improve disease-free and 5 yearsurvival rate compared to the control group in RUNX3 positive cases. On Cox regression multivariate analysis,postoperative adjuvant chemotherapy (P<0.01) was an independent prognostic factor for RUNX3 positive cases,suggesting that postoperative TP may be effective as adjuvant chemotherapy for stage IIA esophageal cancerpatients with RUNX3 positive lesions.