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TERT promoter mutations and recurrence patterns in differentiated thyroid carcinoma
Hyun Jin Ryu1, Ji Hyun Yoo2, Da Eun Leem3
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
Endocrine-Related Cancer
|January 28, 2026
Summary
TERT promoter mutations (TERT-MT) in differentiated thyroid carcinoma (DTC) patients are linked to continuous recurrence and higher mortality risk. TERT-wild type (TERT-WT) shows decreasing recurrence over time, indicating a more favorable prognosis.
Area of Science:
- Endocrinology
- Oncology
- Genetics
Background:
- TERT promoter mutations are established prognostic indicators in differentiated thyroid carcinoma (DTC).
- Understanding recurrence patterns based on TERT mutation status is crucial for long-term patient management.
Purpose of the Study:
- To investigate the impact of TERT promoter mutations on DTC recurrence patterns over time.
- To compare disease-free survival and overall survival between TERT-mutant (MT) and TERT-wild type (WT) DTC patients.
Main Methods:
- Retrospective analysis of 367 DTC patients treated between 1994 and 2004.
- Evaluation of recurrence sites, patterns, and time to recurrence.
- Kaplan-Meier analysis and Cox proportional hazards analysis for survival outcomes.
Main Results:
- TERT mutations and tumor size <2 cm were independent predictors of recurrence.
- TERT-MT patients exhibited a consistently high recurrence rate, unlike TERT-WT patients whose recurrence decreased over time.
- TERT-MT was associated with significantly poorer disease-free survival and increased mortality risk compared to TERT-WT.
Conclusions:
- TERT promoter mutations are significant adverse prognostic factors in DTC, necessitating long-term surveillance.
- TERT-WT is associated with a lower recurrence rate and more favorable treatment outcomes, even in cases of recurrence.
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