Personally I have read Ender's Game before, so obviously I had no problems understanding the references made to the book when I read Speaker for the Dead . However, I wouldn't be sure if the readers with no such previous knowledge would be able to handle all the information. This is partly because there's so many things to remember in the book already (e.g., all the characters' names), and partly because there really isn't that much elaborate explanation to all the things that have already been covered in Ender's Game. Also, I feel that people who haven't read the prequel wouldn't know Ender's story as a child, and thus at the beginning they might actually think that he is an evil character (or is this the author's intention?).
Anyway, for anyone who hasn't read the book yet, you may want to read the plot summary on Wikipedia. The book's plot is quite complicated, and I feel that I have neither the ability nor the energy to write a short yet appropriate summary for the novel. There are simply too many things, and too many new terms that are relevant to the story.
Overall, I really liked this book, more so than Ender's Game. I especially liked the concept of the Speaker of the Dead, someone who would tell the complete truth about a deceased person's life. Also, I feel that its plot and structure were very complete. From the very beginning, Card made me to know more about the piggies and why they would kill Pipo. Throughout the novel, some information began to be disclosed and more events occured, making me even more eager to find out the truth about the piggies' killings. And at the end, the truth was revealed convincingly, with no flaw in the explanation.
Furthermore, I really liked the way how Card illustrated the characters, and I enjoyed reading about the characters' relationships with each other. Each character was sophisticated and unique, and I think Card did an excellent job bringing these characters to life.
In short, this novel was great.