{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T16:50:14Z","timestamp":1789750214096,"version":"4.0.1"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005743","name":"Universit\u00e0 Cattolica del Sacro Cuore","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005743","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Updates Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Occult lymph node metastases occur in up to 50% of patients with clinically node-negative papillary thyroid carcinoma eligible for thyroid lobectomy. Nevertheless, the 2025-ATA guidelines discourage routine prophylactic ipsilateral central neck dissection in clinically node-negative clinical T1b\u2013T2 low-risk disease. This multicentric retrospective study evaluated the impact of routine ipsilateral central neck dissection on recurrence risk stratification in patients with unifocal clinically node-negative clinical T1b\u2013T2 papillary thyroid carcinoma eligible for thyroid lobectomy. Among 9,028 thyroidectomies performed in four referral centres, 264 patients met the inclusion criteria. Lymph node metastases were found in 135 (51.1%) patients, with extranodal extension in 8.9% of node-positive cases. Median tumour size was 12\u00a0mm. Final histopathology showed pT1a disease in 88 (33.3%), pT1b in 165 (62.5%), and pT2 in 11 (4.2%). Extrathyroidal extension, vascular invasion, multifocality, and aggressive histologic variants were observed in 12.1, 60.6, 43.2, and 18.9%, respectively. According to the 2025-ATA risk stratification system, excluding pathologic nodal status, 60 (22.7%) patients were low risk, 31 (11.8%) low\u2013intermediate risk, 170 (64.4%) intermediate\u2013high risk, and 3 (1.1%) high risk. After inclusion of nodal status, 54 (20.4%) were low risk, 24 (9.1%) low\u2013intermediate risk, 171 (64.8%) intermediate\u2013high risk, and 15 (5.7%) high risk (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Overall, 8% of patients experienced risk upgrading, and &gt;\u200970% were classified in higher-risk categories. Pathologic nodal assessment substantially modifies recurrence risk stratification in clinical node-negative T1b\u2013T2 papillary thyroid carcinoma eligible for thyroid lobectomy, supporting routine ipsilateral central neck dissection for staging and tailored surgical decision-making.\n                  <\/jats:p>","DOI":"10.1007\/s13304-026-02759-8","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T11:52:31Z","timestamp":1784634751000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Routine pathological nodal status evaluation significantly modifies 2025 ATA risk category of patients with unifocal cN0 cT1b-T2 PTC eligible for thyroid lobectomy: results from a multicentre international study"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0865-700X","authenticated-orcid":false,"given":"Francesco","family":"Pennestr\u00ec","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Laurino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscilla Francesca","family":"Procopio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatih","family":"Tunca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Traini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmela","family":"De Crea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kemal","family":"Alagol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Carnassale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena Pia","family":"Cerviere","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Corsello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierpaolo","family":"Gallucci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yalin","family":"Iscan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irem","family":"Karatas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamaria","family":"Martullo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Mattia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Pontecorvi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Prioli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Pia","family":"Ricciato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther Diana","family":"Rossi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Raffaelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"2759_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1089\/THY.2015.0020","volume":"26","author":"BR Haugen","year":"2016","unstructured":"Haugen BR, Alexander EK, Bible KC et al (2016) 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. 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Priscilla Francesca Procopio, Francesco Pennestr\u00ec, Antonio Laurino and Pierpaolo Gallucci have a consultant agreement with Medtronic. Fatih Tunca, Emanuela Traini, Carmela De Crea, Kemal Alagol, Giulia Carnassale, Milena Pia Cerviere, Andrea Corsello, Yalin Iscan, Irem Karatas, Annamaria Martullo, Amelia Mattia, Alfredo Pontecorvi, Francesca Prioli, Maria Pia Ricciato, and Esther Diana Rossi, declare that they have no conflicts of interest.\n                      Ethical approval\n                      All\u00a0procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical\u00a0standards.\n                      Informed consent\n                      Informed consent was obtained from all individual participants for whom identifying information is included in this article.\n                      Research involving human participants and\/or animals\n                      This article does not contain any studies with animals performed by any of the authors.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}