biostudies-literatureUnknown33(2)Zhou Y<h4>Background</h4>Accurate preoperative identification of high-volume central lymph node metastasis (hv-CLNM; defined as more than 5 central lymph node metastases) is critical for guiding surgical decisions-lobectomy or total thyroidectomy-in patients with papillary thyroid carcinoma (PTC) clinically diagnosed with central neck lymph node metastasis (cN1a). Total thyroidectomy is generally preferred for patients with hv-CLNM. In contrast, lobectomy may be sufficient for patients with low-volume metastasis (5 or fewer lymph node metastases). This study aimed to identify predictors of hv-CLNM in preoperatively low-risk cN1a and to develop a predictive model to estimate the risk of hv-CLNM, thereby optimizing surgical decision-making.<h4>Methods</h4>A total of 707 patients with pathologicallAnnals of surgical oncology1307-1318https://www.ebi.ac.uk/biostudies/studies/S-EPMC12765736biostudies-literatureSurgical Optimization in Preoperatively Low-risk cN1a PTC: A Predictive Model for High-Volume Central Lymph Node Metastasis.PMC12765736Guo ZHu YLong JKe ZChen WLiang MLi RZhou YXu HXu XfalseSurgical Optimization in Preoperatively Low-risk cN1a PTC: A Predictive Model for High-Volume Central Lymph Node Metastasis.<h4>Background</h4>Accurate preoperative identification of high-volume central lymph node metastasis (hv-CLNM; defined as more than 5 central lymph node metastases) is critical for guiding surgical decisions-lobectomy or total thyroidectomy-in patients with papillary thyroid carcinoma (PTC) clinically diagnosed with central neck lymph node metastasis (cN1a). Total thyroidectomy is generally preferred for patients with hv-CLNM. In contrast, lobectomy may be sufficient for patients with low-volume metastasis (5 or fewer lymph node metastases). This study aimed to identify predictors of hv-CLNM in preoperatively low-risk cN1a and to develop a predictive model to estimate the risk of hv-CLNM, thereby optimizing surgical decision-making.<h4>Methods</h4>A total of 707 patients with pathologicall2026-01-01T00:00:00Z2026 Feb2026-06-06T10:48:51.883Z2026-05-29T03:11:46.18ZS-EPMC127657364112598510.1245/s10434-025-18569-y