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Current preoperative staging for lymph nodal status remains inaccurate. The purpose of this study was to build an artificial neural network (ANN) model to predict pathologic nodal involvement in clinical stage I-II esophageal squamous cell carcinoma (ESCC) patients and then validated the performance of the model. A total of 523 patients (training set 350; test set 173) with clinical staging I-II ESCC who underwent esophagectomy and reconstruction were enrolled in this study. Their post-surgical pathological results were assessed and ana