Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
October 6, 2026 Ā· via Europe PMC
Primary Tumor Location and Lymphatic Spread in Papillary Thyroid Carcinoma.
Fournier I, Zafereo ME, Hamidi S, +20 more, Maniakas A.
AI summary ā for doctors, generated from the abstract only
Primary tumor location within the thyroid did not predict the pattern of neck nodal metastases in papillary thyroid cancer.
What was studied
Single-center retrospective cohort of 1688 patients undergoing thyroidectomy with central and/or lateral neck dissection (1999-2023), comparing nodal metastasis by tumor location (superior, mid, inferior, isthmus).
Key findings
- Central neck positivity was similar across superior (79%), inferior (73%), mid (74%) and isthmic (76%) tumors (P = .22)
- Lateral neck positivity was also comparable across locations; in lateral dissections level III was most often involved (81%), then IV (75%)
Clinical relevance
Suggests tumor location alone should not be used to decide how extensive a neck dissection should be.
Who should care
Limitations
Retrospective single quaternary center; patients selected for dissection, and part of the abstract's results is cut off.
Do not tailor neck dissection extent solely to tumor location.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates ā verify against the original source before acting on it.
Abstract
Objective
Papillary thyroid carcinoma (PTC) frequently metastasizes to cervical lymph nodes. Surgical planning is often based on the presumed central-to-lateral 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.
Study design
Single-center retrospective cohort study.
Setting
Quaternary care center.
Methods
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.
Results
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 (Pā=ā.22). On multivariable logistic regression, central neck positivity did not differ significantly (superior OR: 1.28 [95% CI, 0.74-2.23]; lower OR, 0.88 [95% CI, 0.52-1.50]; mid OR, 0.79 [95% CI, 0.48-1.32]; 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%) (Pā<ā.01). Lastly, superior pole tumors were significantly associated with ipsilateral level III involvement, compared with inferior and mid pole tumors (Pā<ā.01).
Conclusions
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.
DOI
10.1002/ohn.70474
PMID
42836563
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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