{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T17:48:37Z","timestamp":1792000117516,"version":"4.4.0"},"reference-count":33,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"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":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Brain metastases (BMs) from nonanaplastic follicular cell\u2013derived thyroid carcinoma (hereinafter referred to as non-ATC) are rare and not well characterized, with limited evidence guiding treatment and prognostic stratification. We aimed to describe clinical features, treatment patterns, and outcomes of patients with BMs from non-ATC and to develop and validate a disease-specific prognostic score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective international multicenter study included adults with histologically confirmed non-ATC and radiologically documented BMs treated at 19 tertiary referral centers. Clinical, radiological, treatment, and outcome data were collected. Independent predictors of progression-free survival (PFS) and overall survival (OS) were analyzed using Cox regression, and variables identified were used to develop a disease-specific Graded Prognostic Assessment (non-ATC GPA), exploratorily assessed in an independent SEER cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 189 patients were included; median age at BM diagnosis was 59 years (interquartile range [IQR] 48\u201367). First-line BM treatments included stereotactic radiosurgery (27.0%), neurosurgery (23.8%), whole-brain radiotherapy (18.5%), and best supportive care (10.6%). Median PFS was 7.0 months (IQR: 2.9\u201322.4), and median OS was 15.0 months (IQR: 4.0\u201338.4). Independent predictors of shorter OS were age &gt;75 years, Eastern Cooperative Oncology Group performance status \u22652, papillary histology, extracranial metastases, and \u22654 BM. The GPA stratified patients into four prognostic groups with median OS ranging from 72.6 months in the highest-score group to 3.7 months in the lowest. An exploratory SEER-based assessment showed survival differences across adapted prognostic groups (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.036), although this analysis was limited by the absence of all key GPA variables.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>BMs from non-ATC are associated with poor survival and marked prognostic heterogeneity. The proposed GPA may provide a useful framework for prognostic stratification, pending further validation in independent datasets to support individualized management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10507256261473771","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T14:24:11Z","timestamp":1785767051000},"page":"940-950","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic Stratification of Brain Metastases from Nonanaplastic Follicular Cell\u2013Derived Thyroid Carcinoma: Results of an International Multicenter Retrospective Study"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7021-9860","authenticated-orcid":false,"given":"Antonio","family":"Prinzi","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Endocrinology Unit, Garibaldi-Nesima Medical Center, University of Catania, Catania, Italy."},{"name":"Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evert F.S.","family":"van Velsen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, The Netherlands."},{"name":"Department of Internal Medicine, Erasmus MC Bone Center, Erasmus Medical Center, Rotterdam, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolanta","family":"Krajewska","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Endocrine Oncology, Maria Sk\u0142odowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Kolton","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Endocrine Oncology, Maria Sk\u0142odowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inbar","family":"Finkel","sequence":"additional","affiliation":[{"name":"Oncology Division, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyona","family":"Kampel","sequence":"additional","affiliation":[{"name":"Oncology Division, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Kiesewetter","sequence":"additional","affiliation":[{"name":"Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ladislaia","family":"Wolff","sequence":"additional","affiliation":[{"name":"Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mouhammed Amir","family":"Habra","sequence":"additional","affiliation":[{"name":"Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA."},{"name":"Section of Endocrinology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vania","family":"Balderrama-Brondani","sequence":"additional","affiliation":[{"name":"Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won Gu","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chae A.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."},{"name":"Department of Endocrinology and Metabolism, Inha University College of Medicine, Incheon, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Spitzweg","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV, LMU University Hospital of Munich, LMU Munich, Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktoria Florentine","family":"Koehler","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV, LMU University Hospital of Munich, LMU Munich, Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merel Tessa","family":"Stegenga","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wouter T.","family":"Zandee","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thera P.","family":"Links","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Luiza","family":"Maia","sequence":"additional","affiliation":[{"name":"Hospital de Cl\u00ednicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael Selbach","family":"Scheffel","sequence":"additional","affiliation":[{"name":"Hospital de Cl\u00ednicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Sheehan","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA."},{"name":"Department of Radiation Oncology, University of Virginia, Charlottesville, Virginia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matti L.","family":"Gild","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, Royal North Shore Hospital, Sydney, Australia."},{"name":"Faculty of Medicine and Health, University of Sydney, Sydney, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2742-7085","authenticated-orcid":false,"given":"Fabian","family":"Pitoia","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Head Thyroid Section, Hospital de Clinicas, University of Buenos Aires, Viamonte, Argentina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Jiskra","sequence":"additional","affiliation":[{"name":"3rd Department of Medicine, 1st Faculty of Medicine, General University Hospital, Charles University, Prague, Czech Republic."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajeev","family":"Parameswaran","sequence":"additional","affiliation":[{"name":"Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Paschke","sequence":"additional","affiliation":[{"name":"Departments of Medicine, Oncology, Pathology and Laboratory Medicine, Biochemistry and Molecular Biology, and Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Liscak","sequence":"additional","affiliation":[{"name":"Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4294-3624","authenticated-orcid":false,"given":"Ali S.","family":"Alzahrani","sequence":"additional","affiliation":[{"name":"Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi 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Edward","family":"Visser","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Frasca","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Endocrinology Unit, Garibaldi-Nesima Medical Center, University of Catania, Catania, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasqualino","family":"Malandrino","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Endocrinology Unit, Garibaldi-Nesima Medical Center, University of Catania, Catania, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12022-022-09707-3"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2014.0173"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-2838"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-014-4058-y"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.82.11.4386"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.80.7.7608252"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1210\/js.2018-00241"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10585-023-10208-8"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2014.0335"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/10507256251363120"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.01255"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000421-198212000-00014"},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2008.10.026"},{"key":"e_1_3_2_16_1","unstructured":"15.Anonymous. 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