ArticleScientific reports2026
Superior prognostic performance of modified N staging incorporating N1c in papillary thyroid carcinoma.
Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
The current N staging system for papillary thyroid carcinoma (PTC) faces challenges due to prognostic heterogeneity among different lymph node metastasis (LNM). This study aims to evaluate the prognostic significance of various LNM regions and refine the current N staging system (N0, N1a, N1b). We analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database, including 40,371 PTC patients between 2004 and 2015. Patients were categorized into different groups: N0, N1a, N1b and a new hypothetical and modified N stage, N1c. The effect of different LNM on Cancer-specific survival (CSS) was assessed using hazard ratios (HRs) and absolute survival differences. Cox and Fine-Gray models estimated HRs with 95% confidence intervals (CIs), while logistic regression identified risk factors. The performance of staging systems was compared using C-index, Brier score, and Akaike Information Criterion. We found that patients with LNM in levels I, Vb, and VII showed a similar survival pattern with similarly poor CSS. The introduction of the N1c category revealed a more aggressive clinicopathological characteristics among these patients. Multivariate Cox analysis determined that N1c was associated with the worst CSS (adjusted HR (95%CI) for N1a, N1b, and N1c vs. N0: 2.62 (2.04-3.36), 3.93 (3.04-5.10), and 5.51 (4.02-7.55), respectively). Multivariate logistic analysis identified independent risk factors for N1c LNM including younger age, male, larger size, extrathyroidal extension, and multifocality. The modified N staging system demonstrated superior performance. Therefore, the N staging system for PTC was improved by introducing this hypothetical and modified N1c category for LNM in levels I, Vb, and VII, based on their similar clinical behavior and poor prognosis.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.