Predicting preoperative lymph node metastasis in esophageal cancer: Advancement and challenges

Accurate preoperative prediction of lymph node metastasis is crucial for developing clinical management strategies for patients with esophageal cancer. In this letter, we present our insights and opinions on a new nomogram proposed by Xu et al. Although this research has great potential, there are still concerns regarding the small sample size, limited consideration of biological complexity, subjective image segmentation, incomplete image feature extraction and statistical analyses. Furthermore, we discuss how to achieve more robust and accurate predictive performance in future research.