We report our experience with tailored treatment comprising resection or radiotherapy for postoperative recurrence of esophageal cancer in 73 patients(35.4%)who were diagnosed with recurrent esophageal cancer after curative resection. The initial recurrence patterns included 7 patients(3.4%)with local recurrence, 38 patients(18.4%)with lymphatic recurrence, 40 patients(19.4%)with hematologic metastases, and 12 patients(5.8%)with dissemination.Twenty -three patients had solitary lung metastases, and good local control was achieved by surgical resection alone.The success rate of intensity modulated radiation therapy (IMRT) for local control was 64.1%, and IMRT was considered effective and less invasive. The 2-year survival rate after successful treatment for recurrence was 53.5%, vs 5.8% after unsuccessful treatment. Improved prognosis for patients with recurrent esophageal cancer can be expected when adequate local control is achieved according to recurrence pattern by surgical resection or IMRT.