{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T12:34:37Z","timestamp":1787747677667,"version":"build-2784847793"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T00:00:00Z","timestamp":1576800000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T00:00:00Z","timestamp":1576800000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T00:00:00Z","timestamp":1576800000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cervical lymph node metastasis is a prognostic factor of papillary thyroid carcinoma (PTC). Skip metastasis (central lymph node negative and lateral lymph node positive) of PTC is not uncommon. This study aimed to retrospectively investigate the risk factors for skip metastasis in PTC and develop a prediction model for skip metastasis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 745\u00a0PTC patients underwent total thyroidectomy and central plus lateral lymph node dissection at the First Affiliated Hospital of Chongqing Medical University from January 2012 to December 2017. Clinicopathological characteristics were collected and analyzed. Univariate and multivariate analyses were performed to detect the risk factors for skip metastasis. A prediction model was established based on the results of multivariate analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The skip metastasis rate was 9.7% (72\/745). Age\u2009&gt;\u200955 years (OR 2.63, 95% CI 1.34\u20135.04, <jats:italic>p<\/jats:italic>\u2009=\u20090.004), tumor located in the upper portion (OR 4.15, 95% CI 2.30\u20137.63, <jats:italic>p<\/jats:italic>\u2009=\u20090.001), and unilaterality (OR 2.76, 95% CI 1.14\u20138.23, <jats:italic>p<\/jats:italic>\u2009=\u20090.040) were independent risk factors for skip metastasis. Clinically lymph node\u2010negative (cN0) patients with tumor in the upper portion (24.6%, 43\/175) had higher possibility of skip metastasis than those of clinically lateral lymph node\u2010positive (cN1b) patients (5.9%, 10\/169) (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). The area under the receiver operating characteristic curve of prediction model was 0.734 and 0.740\u00a0in derivation group and validation group, respectively. However, skip metastasis was not associated with tumor\u2010free survival rate of PTC patients (<jats:italic>p<\/jats:italic>\u2009=\u20090.274).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Age\u2009&gt;\u200955 years, tumor located in the upper portion, and unilaterality may increase the risk of skip metastasis. We developed the first prediction model for skip metastasis based on clinicopathological parameters in PTC patients.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-019-05332-0","type":"journal-article","created":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T15:04:10Z","timestamp":1576854250000},"page":"1498-1505","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Risk Factors for and Prediction Model of Skip Metastasis to Lateral Lymph Nodes in Papillary Thyroid Carcinoma"],"prefix":"10.1002","volume":"44","author":[{"given":"Daixing","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Endocrine and Breast Surgery The First Affiliated Hospital of Chongqing Medical University 400016 Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huapeng","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit, Affiliated Hangzhou First People's Hospital Zhejiang University School of Medicine 310006 Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Oncology The Second Affiliated Hospital of Chongqing Medical University 400010 Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tielin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Breast and Thyroid Surgery The Third People's Hospital of Chengdu 610031 Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Center West China Hospital of Sichuan University 610041 Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinliang","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Breast Surgery The First Affiliated Hospital of Chongqing Medical University 400016 Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2014.1"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2004.14.1056"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/02841860903544600"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11864\u2010005\u20100035\u20109"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445\u20102197.2010.05334.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313480507100907"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24568"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2011.10.006"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23391"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010012\u20101476\u20105"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010017\u20103698\u20102"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12957\u2010018\u20101336\u20103"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2008.0244"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.4174\/astr.2015.88.2.63"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/1878194"},{"issue":"2","key":"e_1_2_7_17_1","first-page":"59","article-title":"Skip 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December 2019","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This work was supported by the ethics committee of the First Affiliated Hospital of Chongqing Medical University.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}