{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:23:48Z","timestamp":1786123428561,"version":"build-2736575974"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp;amp; Neck"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Skip metastasis (SM), defined as lateral lymph node metastasis without central involvement, is an important but unpredictable spread pattern in papillary thyroid carcinoma (PTC). This study aimed to determine its prevalence, identify clinicopathologic predictors, and develop a preoperative risk model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 130 PTC patients with histologically confirmed lateral metastasis who underwent total thyroidectomy, bilateral central neck dissection, and unilateral or bilateral lateral dissection at three tertiary centers between 2019 and 2025. Clinicopathologic and nodal variables were compared between the SM and non\u2010skip metastasis (NSM) groups. Independent predictors were evaluated using multivariable logistic regression, and model performance was assessed with ROC AUC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>SM occurred in 12.3% of patients. SM was associated with older age, upper\u2010pole tumor location, solitary intrathyroidal focus, and lower nodal burden. Independent predictors were age \u2265\u200939.5\u2009years and upper\u2010pole location, while same\u2010lobe multifocality was inversely associated. The model showed good discrimination with an AUC of 0.841.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Older patients with solitary upper\u2010pole PTC warrant meticulous preoperative lateral\u2010neck assessment. A simplified preoperative model incorporating age, tumor topography, and multifocality may support risk\u2010based surgical planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70257","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T01:40:15Z","timestamp":1775526015000},"page":"2442-2448","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinicopathologic Predictors and Nodal Burden Pattern of Skip Metastasis in Papillary Thyroid Carcinoma: A Multicenter Study"],"prefix":"10.1002","volume":"48","author":[{"given":"Muge Yurdacan","family":"Sahin","sequence":"first","affiliation":[{"name":"Department of General Surgery Bakirkoy Sadi Konuk Training and Research Hospital, University of Health Sciences  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet C.","family":"Dural","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Faculty of Medicine Liv Hospital, Istinye University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Husnu","family":"Aydin","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Faculty of Medicine Medipol Ac\u0131badem District Hospital, Medipol University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6305-2957","authenticated-orcid":false,"given":"Tugba Matlim","family":"Ozel","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Division of Endocrine Surgery University of Health Sciences, Basaksehir Cam and Sakura City Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4362-2240","authenticated-orcid":false,"given":"Sezer","family":"Akbulut","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Division of Endocrine Surgery University of Health Sciences, Basaksehir Cam and Sakura City Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0478-7723","authenticated-orcid":false,"given":"Aykut","family":"Celik","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Division of Endocrine Surgery University of Health Sciences, Basaksehir Cam and Sakura City Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gorkem","family":"Yildiz","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Division of Endocrine Surgery University of Health Sciences, Basaksehir Cam and Sakura City Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firdevs M.","family":"Onuktav","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Division of Endocrine Surgery University of Health Sciences, Basaksehir Cam and Sakura City Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huseyin","family":"Karatay","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Health Sciences, Basaksehir Cam and Sakura City Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gokce","family":"Aylaz","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Faculty of Medicine Liv Hospital, Istinye University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deniz","family":"Guzey","sequence":"additional","affiliation":[{"name":"Department of General Surgery Bakirkoy Sadi Konuk Training and Research Hospital, University of Health Sciences  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuri A.","family":"Sahbaz","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Faculty of Medicine Hisar Hospital, Gelisim University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8219-1100","authenticated-orcid":false,"given":"Ozden","family":"Canoz","sequence":"additional","affiliation":[{"name":"Department of General Surgery Bakirkoy Sadi Konuk Training and Research Hospital, University of Health Sciences  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"Surek","sequence":"additional","affiliation":[{"name":"Department of General Surgery Bakirkoy Sadi Konuk Training and Research Hospital, University of Health Sciences  Istanbul 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