{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T03:49:23Z","timestamp":1793245763821,"version":"4.5.0"},"reference-count":19,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">TERT<\/jats:italic>\n                      promoter mutations in thyroid cancer are associated with aggressive disease, including recurrence, distant metastasis, and disease-related mortality. We aim to assess histological and disease-related outcomes when\n                      <jats:italic toggle=\"yes\">TERT<\/jats:italic>\n                      mutation is detected alone or with other alterations during preoperative testing.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A retrospective, single-institution study was performed, including all adult patients undergoing initial diagnostic thyroid nodule evaluation with\n                      <jats:italic toggle=\"yes\">TERT<\/jats:italic>\n                      promoter mutation (C228T\/C250T) detected in preoperative thyroid fine needle aspiration samples using TSv3 testing.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 70 thyroid nodules, 18 (26%) were isolated (iTERT), and 52 (74%) were associated with \u22651 concurrently detected mutation (TERT+). The most common additional abnormalities were\n                      <jats:italic toggle=\"yes\">\n                        BRAF\n                        <jats:sup>V600E<\/jats:sup>\n                      <\/jats:italic>\n                      (23, 44%), RAS (19, 37%), and copy number alterations (CNA; 15, 29%). Patients with iTERT were older than those with TERT+ nodules (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.007). While nodule size was similar between the two groups (mean size 3.2 cm,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.18), Bethesda III\/IV cytology was more likely with iTERT (94% vs. Bethesda V\/VI 56%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.007). Histology was available for 9 (50%) iTERT and 51 (98%) TERT+ nodules and malignancy was higher with preoperative detection of TERT+ compared with iTERT (96% vs. 67%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.02). Poorly differentiated or anaplastic cancers were diagnosed in 33% of the malignancies at an equivalent rate in both cohorts. At median follow-up of 13.1 months (interquartile range 26.2, 7.2\u201333.4), distant metastasis occurred in 32.7% of patients including 17% (1\/6) with iTERT versus 33% of patients with TERT+ (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.65). None of the iTERT patients had locoregional recurrence as compared with 25% of TERT+ patients (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.31).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      When preoperatively detected,\n                      <jats:italic toggle=\"yes\">TERT<\/jats:italic>\n                      promoter mutations are more often seen in association with additional driver mutations or other genetic alterations such as CNA, but when present, carries a very high risk of malignancy (93%). Up to 1\/3 are poorly differentiated or anaplastic thyroid cancer, and this likelihood is equivalent when\n                      <jats:italic toggle=\"yes\">TERT<\/jats:italic>\n                      is present in isolation or in combination with other mutation. Thus, surgery should be strongly considered in iTERT nodules, and total thyroidectomy should be favored when TERT+ is identified.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10507256251370304","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T18:52:36Z","timestamp":1759949556000},"page":"1138-1144","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Disease-Specific and Histological Outcomes of Preoperative TERT Promoter Mutation Detected in Isolation or in Combination with Other Mutations in Thyroid Neoplasms"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1547-0008","authenticated-orcid":false,"given":"Michael","family":"Calcaterra","sequence":"first","affiliation":[{"name":"Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa","family":"Sada","sequence":"additional","affiliation":[{"name":"Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esra","family":"Karslioglu-French","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8753-5280","authenticated-orcid":false,"given":"Elena M.","family":"Morariu","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly L.","family":"McCoy","sequence":"additional","affiliation":[{"name":"Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly M.","family":"Ramonell","sequence":"additional","affiliation":[{"name":"Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saba","family":"Kurtom","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Washington School of Medicine, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. Paul","family":"Ohori","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simion I.","family":"Chiosea","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raja R.","family":"Seethala","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally E.","family":"Carty","sequence":"additional","affiliation":[{"name":"Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina N.","family":"Nikiforova","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2239-1095","authenticated-orcid":false,"given":"Yuri E.","family":"Nikiforov","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linwah","family":"Yip","sequence":"additional","affiliation":[{"name":"Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/mgg3.1288"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1530\/etj-23-0114"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000003580"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2023.1494"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2023.0060"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/ncomms3185"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1530\/erc-13-0210"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1530\/erc-15-0533"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgad220"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.3803\/EnM.2022.1477"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1158\/1541-7786.Mcr-16-0003"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcte.2023.100329"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2018.0779"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1158\/1541-7786.Mcr-23-0144"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0582"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-023-02937-7"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.2103\/7\/gs-20-416"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zrad029"}],"container-title":["Thyroid\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10507256251370304","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10507256251370304","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10507256251370304","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T08:56:32Z","timestamp":1780044992000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10507256251370304"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,20]]},"references-count":19,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1177\/10507256251370304"],"URL":"https:\/\/doi.org\/10.1177\/10507256251370304","relation":{},"ISSN":["1050-7256","1557-9077"],"issn-type":[{"value":"1050-7256","type":"print"},{"value":"1557-9077","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,20]]}}}