TERT Promoter Variants, Older Age, and Prognosis in Papillary Thyroid Carcinoma

Is the association between older age and poor prognosis in papillary thyroid carcinoma explained by TERT promoter variants? In this multi-institutional cohort study of 1555 patients with papillary thyroid carcinoma, the prevalence of TERT promoter variants increased progressively with age and was independently associated with higher disease-specific mortality. Adjustment for TERT promoter variant status substantially attenuated the association between older age and disease-specific mortality, suggesting that the adverse prognostic effect of age may be mediated, at least partially, by the age-associated increase in TERT promoter variants. The findings of this study suggest that risk stratification in papillary thyroid carcinoma may benefit from integrating clinicopathologic and genomic biomarkers while moving away from reliance on a strict age cutoff.

Corresponding Author: Jennifer R. Wang, MD, PhD, Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1445, Houston, TX 77030 (jrwang@mdanderson.org).

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