Observational studyFrontiers in endocrinology2026
Skip metastases in papillary thyroid carcinoma: evidence from a multicenter European retrospective study.
Observational study in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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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.
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Who cites it
1 citing paper in PubMed.
- Interpretable machine learning distinguishes skip from continuous metastasis in N1b papillary thyroid carcinoma.Scientific reports · 2026Article
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Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Papillary thyroid carcinoma (PTC) frequently involves cervical lymph nodes. Lateral nodal involvement without central compartment disease (Skip Metastasis, SM) poses diagnostic and staging challenges. We aimed to characterize clinicopathological features of SM in a large multicenter European cohort comparing SM+ (lateral only) and SM- (central + lateral) disease. Materials and methods: We conducted a retrospective study across four high-volume European centers (01/2020-12/2022). Adults with histologically proven PTC, confirmed lateral cervical metastases, and both central (level VI) and lateral (levels II-IV) dissections were included. Additional subanalyses among pT1a and cases with >2 central nodes retrieved were employed to control for confounders. Results: Among 283 patients, 48 (17.0%) were SM +. SM+ patients were older (47 vs 39 years, p=0.006) and had smaller primaries (12 vs 16 mm, p=0.008), fewer microfoci (2 vs 3, p=0.013), fewer lateral nodes retrieved (22 vs 25, p=0.004), fewer positive nodes (2 vs 4, p<0.001), and smaller largest metastatic node (14.5 vs 18.5 mm, p=0.010). Follicular variant was prevalent in SM+ (18.8% vs 4.3%; p=0.001). Features of aggressiveness were less frequent in SM+: multifocality (62.5% vs 74.9%, p=0.016), bilaterality (37.5% vs 52.8%, p=0.024), microscopic ETE (33.3% vs 52.3%, p=0.016), LVI (14.6% vs 47.7%, p<0.001), and extranodal extension (8.3% vs 20.4%, p=0.043). Findings persisted in different subanalyses (>2 central nodes; n=252. pT1a tumors n=73). In multivariable analysis, central nodal yield (OR 1.13, p=0.003) and LVI (OR 6.5, p=0.005) were associated with SM-, whereas follicular variant was inversely associated (OR 0.24, p=0.028). Conclusion: SM were not uncommon and associated with a less aggressive clinicopathologic profile and increased proportion of follicular variant. While limited central nodal yield may pose false positive risks, key associations persisted after adjustment. Prospective studies are warranted to refine risk stratification and surgical planning.
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