{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T08:49:03Z","timestamp":1791622143977,"version":"4.3.4"},"reference-count":60,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Molecular testing (MT) aids in the management of indeterminate thyroid nodules; however, regional differences remain unexamined. This meta\u2010analysis compares MT's clinical impact between Western and Asian cohorts. This study hypothesized that regional disparities in malignancy prevalence, molecular platforms, and practice patterns would yield divergent clinical applications of MT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review up to April 2025 identified studies reporting the surgical management and histopathological outcomes of indeterminate nodules in Asian and Western cohorts, stratified by use of MT versus no MT. Pooled proportions were calculated via random\u2010effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 127 included studies (100 Western; 27 Asian), MT was performed in 96 Western and 21 Asian studies. Western studies predominantly used commercial panels, whereas Asian studies favored smaller, mutation\u2010specific assays. Without MT, resection rates were 66.8% (95% CI, 55.1%\u201376.7%) in Western studies versus 53.9% (95% CI, 43.5%\u201364.0%) in Asian studies (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.11). With MT, rates fell to 42.5% versus 37.4% (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.275), respectively. Risk of malignancy (ROM) was significantly higher in Asian cohorts, both without MT (48.0% vs. 29.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.005) and with MT (62.7% vs. 37.1%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.001), which persisted after exclusion of follicular thyroid neoplasm with papillary\u2010like nuclear features. In Western studies, second\u2010generation platforms achieved lower resection rates (36.1% vs. 48.3%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.001) but higher ROM (42.8% vs. 34.4%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.005) than first\u2010generation tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MT reduces surgical interventions across both regions by serving divergent roles. In the West, MT functions as a rule\u2010out tool to avoid surgery via comprehensive panels. In Asia, where baseline malignancy is higher and practice is relatively conservative, MT provides confirmatory risk stratification via focused mutation panels. Regionally tailored guidelines are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncy.70154","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:01:42Z","timestamp":1790229702000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Western versus Asian utilization of molecular testing for indeterminate thyroid nodules: A meta\u2010analysis of divergent clinical impact"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1783-7689","authenticated-orcid":false,"given":"Chanchal","family":"Rana","sequence":"first","affiliation":[{"name":"Department of Pathology King George's Medical University  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6965-5863","authenticated-orcid":false,"given":"Truong","family":"Phan\u2010Xuan Nguyen","sequence":"additional","affiliation":[{"name":"Department of Pathology School of Medicine University of Medicine and Pharmacy at Ho Chi Minh City  Ho Chi Minh City Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6843-3708","authenticated-orcid":false,"given":"Chan Kwon","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Pathology Seoul St. Mary's Hospital College of Medicine The Catholic University of Korea  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4203-5696","authenticated-orcid":false,"given":"Andrey","family":"Bychkov","sequence":"additional","affiliation":[{"name":"Department of Pathology Kameda Medical Center  Kamogawa City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0347-7264","authenticated-orcid":false,"given":"Kennichi","family":"Kakudo","sequence":"additional","affiliation":[{"name":"Department of Pathology and Thyroid Disease Center Izumi City General Hospital  Izumi 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