A 63-year-old man who was diagnosed T1b esophageal cancer, for which transthoracic esophagectomy was indicated, received mediastinoscopy-assisted transhiatal esophagectomy because of the previous right thoracotomy for pulmonary tuberculosis. CT study revealed an upper mediastinal lymph-node metastasis 3 years after surgery. He was treated with chemotherapy of daily continuous 5-FU infusion (500 mg/day) and daily nedaplatin (5 mg x 5 days/week) for 4 weeks combined with concurrent radiotherapy (44 Gy). A partial response was achieved for the metastatic lymph-node lesion after chemo-radiotherapy, so boost radiotherapy (16 Gy) was given to the patient. He is still alive now without a re-growth of the lymph-node metastasis. It is important to follow-up the patient with advanced esophageal cancer carefully who received mediastinoscopy-assisted transhiatal esophagectomy.