We included all nine studies in the meta-analysis [10,11,16,17,19–22,24] (heterogeneity: Chi2 = 8.58, I2 = 18%, Z = 3.55, P < .01, fixed efforts model), finding that TERT promoter mutations can increase the risk of lymph node metastasis with the odds ratio (OR), 1.85; 95% CI; [1.32–2.59] P = .0004 (Fig. 2). Here, TERT is linked to metastatic malignant neoplasm in the lymph nodes.