Doubles to centre Tat Whaleboat and lock Dean Jones helped Paterson see of a spirited challenge from Karuah at Coronation Oval on Saturday.
With the game transferred from Paterson Sportsground, The River ran in five tries in their 28-22 win over Karuah, with Lindsay Jones also crossing for a four-pointer and Jay Smith landing four of five shots on goal.
The fifth placed Karuah ran in four tries against Paterson, who were coming off a hard-fought 24-16 win Gloucester the week before.
Paterson remain in second spot, two points behind competition leaders Stroud and four points ahead of Dungog who have a catch-up game against Tea Garden this Friday night.
Paterson men have this weekend off before a three-game run into the semi-finals.
Women record comfortable win
The Paterson Ladies League Tag team had a comfortable 30-10 win against Aberglasslyn in their relocated game at Coronation Oval on Saturday.
The River ran in five tries to two, with two of the five goals converted.
The win keeps them in third place on the ladder, with a big challenge in a round 12 catch up game against top of the table side Clarence Town on Friday night.