{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:54:15Z","timestamp":1791291255582,"version":"4.3.0"},"reference-count":8,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Papillary thyroid carcinoma (PTC) frequently metastasizes to cervical lymph nodes. Surgical planning is often based on the presumed central\u2010to\u2010lateral pattern of spread. The extent of central and lateral neck dissection remains controversial, with recommendations largely derived from small series. The study aimed to determine whether primary tumor location can guide the extent of neck dissection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Single\u2010center retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Quaternary care center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with PTC undergoing primary thyroid surgery with a central and\/or lateral neck dissection (CND and\/or LND) between 1999 and 2023 were evaluated. Tumor location (superior, mid, inferior pole, or isthmus) was determined by ultrasound and confirmed on pathology. The primary outcome was pattern of nodal metastases by tumor location.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1688 patients (median age 45 years; 67% female), 99% underwent CND and 45% LND. Central neck positivity was similar across superior (79%; 262\/333), inferior (73%; 286\/393), mid (74%; 626\/849), and isthmic (76%; 71\/94) tumors (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.22). On multivariable logistic regression, central neck positivity did not differ significantly (superior OR: 1.28 [95% CI, 0.74\u20102.23]; lower OR, 0.88 [95% CI, 0.52\u20101.50]; mid OR, 0.79 [95% CI, 0.48\u20101.32]; compared with isthmic. LND unadjusted and adjusted positivity rates were also comparable across primary tumor location. In patients undergoing LND, level III was most frequently involved (81%), followed by levels IV (75%), IIa (60%), Vb (36%), and IIb (9%) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.01). Lastly, superior pole tumors were significantly associated with ipsilateral level III involvement, compared with inferior and mid pole tumors (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients undergoing therapeutic neck dissection for PTC, primary tumor location did not predict nodal distribution and should not determine the extent of neck dissection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70474","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:12:00Z","timestamp":1791288720000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Primary Tumor Location and Lymphatic Spread in Papillary Thyroid Carcinoma"],"prefix":"10.1002","author":[{"given":"Isabelle","family":"Fournier","sequence":"first","affiliation":[{"name":"Department of Head &amp; Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark E.","family":"Zafereo","sequence":"additional","affiliation":[{"name":"Department of Head &amp; Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Hamidi","sequence":"additional","affiliation":[{"name":"Department of Endocrine Neoplasia and Hormonal Disorders The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erich M.","family":"Sturgis","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Baylor College of Medicine Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven G.","family":"Waguespack","sequence":"additional","affiliation":[{"name":"Department of Endocrine Neoplasia and Hormonal Disorders The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle D.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Mohsen","family":"Hosseini","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mimi I.","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Endocrine Neoplasia and Hormonal Disorders The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul H.","family":"Graham","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Banuchi","sequence":"additional","affiliation":[{"name":"Department of Head &amp; Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil D.","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Head &amp; Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam N.","family":"Lango","sequence":"additional","affiliation":[{"name":"Department of Head &amp; Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer R.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Head &amp; Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria E.","family":"Cabanillas","sequence":"additional","affiliation":[{"name":"Department of Endocrine Neoplasia and Hormonal Disorders The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naifa L.","family":"Busaidy","sequence":"additional","affiliation":[{"name":"Department of Endocrine Neoplasia and Hormonal Disorders The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramona","family":"Dadu","sequence":"additional","affiliation":[{"name":"Department of Endocrine Neoplasia and Hormonal Disorders The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanka","family":"Iyer","sequence":"additional","affiliation":[{"name":"Department of Endocrine Neoplasia and Hormonal Disorders The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven I.","family":"Sherman","sequence":"additional","affiliation":[{"name":"Department of Endocrine Neoplasia and Hormonal Disorders The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachin K.","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Head &amp; Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan P.","family":"Goepfert","sequence":"additional","affiliation":[{"name":"Department of Head &amp; Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth G.","family":"Grubbs","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salmaan","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4354-2841","authenticated-orcid":false,"given":"Anastasios","family":"Maniakas","sequence":"additional","affiliation":[{"name":"Department of Head &amp; Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1501993"},{"key":"e_1_2_9_3_1","unstructured":"Cancer Stat Facts: Thyroid Cancer (SEER database).https:\/\/seer.cancer.gov\/statfacts\/html\/thyro.html"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2011.0312"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/10507256251363120"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/01945998211038318"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2018.10.035"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.02.005"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70474","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ohn.70474","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70474","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:12:01Z","timestamp":1791288721000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.70474"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":8,"alternative-id":["10.1002\/ohn.70474"],"URL":"https:\/\/doi.org\/10.1002\/ohn.70474","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]},"assertion":[{"value":"2026-01-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ohn.70474"}}