TERT Promoter Variants, Not Age Alone, Drive Thyroid Cancer Prognosis

A multi-institutional retrospective cohort study combining data from three US academic centers, TCGA, and AACR GENIE (n=1555, with 169 followed long-term) examined age, TERT promoter status, and survival in papillary thyroid carcinoma. The study reported that TERT promoter variant prevalence rose progressively with age and that among patients 55 or older, 10-year disease-specific survival was 91% for TERT wild-type tumors versus 51% for TERT-variant tumors, with TERT remaining independently associated with worse survival after adjusting for age and TNM stage. The authors suggest that the high prevalence of TERT variants in older patients largely explains the known association between age and worse PTC prognosis, and that TERT status may offer more biologically grounded prognostic information than age.

Most relevant for: Patients aged 55 or older diagnosed with papillary thyroid carcinoma, particularly in risk stratification and staging discussions.

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