{
  "abstract": "Background: The clinical utility of postoperative radioiodine ( ¹³¹ I) ablation remains unclear for patients with initially diagnosed non-distant metastatic papillary thyroid carcinoma (PTC) with harboring TERT promoter(TERT-p) mutations, it is unknown whether ¹³¹ I therapy reduces the risk of persistent or recurrent disease. This study investigated clinicopathological features, 2-year dynamic therapeutic responses and progression-free survival (PFS) in this specific patient cohort.\n\nMethods: A single-center retrospective cohort study enrolled 113 eligible patients, allocated to the ¹³¹ I ablation group (n=62) and non- ¹³¹ I group (n=51). Two-year dynamic risk stratification assessed treatment response. Kaplan–Meier curves and Cox regression models were used for survival analysis.\n\nResults: The predominant TERT-p variant was C228T (89.4%), and most patients carried concurrent BRAF V600E mutations. Only initial surgical approach remained an independent intergroup variable. Within 2 years, 46.0% achieved acceptable responses, associated with sex and primary surgery (p=0.036,p < 0.001). High baseline ATA risk was strongly correlated with structural residual lesions and unfavorable therapeutic response (p < 0.001).No significant between-group differences in response were observed across all ATA risk subgroups. The median follow-up was 4.6 years; 3- and 5-year PFS rates were 67.5% and 39.1%. Age ≥55 years, N1b stage and high baseline ATA risk were independent adverse predictors of PFS. Both 2-year therapeutic response and PFS at the end of follow-up exhibited no statistical differences between the ¹³¹ I group and non- ¹³¹ I group.\n\nConclusions: In this retrospective observational cohort, postoperative ¹³¹ I ablation was not associated with improved PFS among patients with non-distant metastatic TERT-p-mutant PTC. Advanced age, N1b lymphatic metastasis and high baseline ATA risk independently predict poor outcomes. Biologically, TERT-p mutations induce tumor dedifferentiation and impaired iodine uptake, diminishing ¹³¹ I efficacy. Clinically, routine ¹³¹ I yields no survival benefit for this high-risk molecular subgroup, guiding individualized surveillance and avoiding redundant ¹³¹ I exposure.",
  "abstract_shown": true,
  "affiliations": [
    "Department of General Surgery, Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine , ,",
    "Department of Nuclear Medicine, Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine , ,",
    "Department of Pathology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine , ,",
    "Institute of Diagnostic and Interventional Radiology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine , ,"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Xian-Zhao Deng"
    },
    {
      "affs": [
        1
      ],
      "name": "Meng-yue Liu"
    },
    {
      "affs": [
        1
      ],
      "name": "Chen-Tian Shen"
    },
    {
      "affs": [
        1
      ],
      "name": "Hong-Jun Song"
    },
    {
      "affs": [
        0
      ],
      "name": "Jian Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "You-Ben Fan"
    },
    {
      "affs": [
        1
      ],
      "name": "Quan-yong Luo"
    },
    {
      "affs": [
        2
      ],
      "name": "Juan Tang"
    },
    {
      "affs": [
        3
      ],
      "name": "Xiao-er Wei"
    },
    {
      "affs": [
        1
      ],
      "name": "Zhong-Ling Qiu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/acbtn9kn8cyq6.bib",
  "cited_by": 0,
  "doi": "10.3389/fonc.2026.1895987",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661339/?tool=EBI",
  "id": "acbtn9kn8cyq6",
  "issns": [
    "2234-943X"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13661339",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2712|Thyroid Cancer Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7214977538",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661339/pdf/?tool=EBI",
  "pmcid": "PMC13661339",
  "pmid": null,
  "published": "2026-09-30",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/acbtn9kn8cyq6.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:20Z",
      "native_id": "PMC:PMC13661339",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13661339"
    },
    {
      "first_seen": "2026-10-30T12:20:13Z",
      "native_id": "10.3389/fonc.2026.1895987",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1895987/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Thyroid Cancer Diagnosis and Treatment",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Two-year dynamic risk stratification and adjuvant radioiodine efficacy in initial non-distant metastatic papillary thyroid carcinoma harboring TERT promoter mutations",
  "title_text": "Two-year dynamic risk stratification and adjuvant radioiodine efficacy in initial non-distant metastatic papillary thyroid carcinoma harboring TERT promoter mutations",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:13Z",
  "url": "https://research.draconitic.com/paper/acbtn9kn8cyq6",
  "venue": "Frontiers in oncology",
  "versions": []
}