Objective:The current study aims to explore the risk factors for the cervical anastomotic leakage after esophagectomy, establish a nomogram prediction model,and test its predictive ability. Methods:A retrospective analysis was performed on clinical data of 362 patients undergoing radical resection of esophageal carcinoma in Nanjing medical university affiliated cancer hospital between January 2019 and May 2022. The independent risk factors for postoperative cervical anastomotic leakage were analyzed by univariate analysis and multivariable logistic regression analysis. Based on these factors,a nomogram model was established to predict the risk of the cervical anastomotic leakage. The predictive performance of the nomogram was verified by receiver operating characteristic curve(ROC)and calibration curve. Results:The incidence of the postoperative cervical anastomotic leakage was 11.88% (43/362). The multivariable logistic regression analysis showed that diabetes,chronic bronchitis,the history of thoracic or abdominal surgery,neoadjuvant therapy and postoperative pulmonary infection were the independent high risk factors for cervical anastomotic leakage after esophagectomy(P<0.05). A nomogram prediction model was established based on these factors. The area under the receiver operator characteristic curve achieved 0.844(95% CI 0.771~0.918).The calibration curve displayed a general consistency between the prediction and ideal curves. Conclusion:Diabetes,chronic bronchitis,the history of thoracic or abdominal surgery, neoadjuvant therapy and postoperative pulmonary infection are the independent high risk factors for the cervical anastomotic leakage after esophagectomy,and clinical prediction model shows good evaluation efficacy and provides a reference for the assessment and early intervention of the cervical anastomotic leakage.