Int J Thyroidol.  2024 Nov;17(2):286-294. 10.11106/ijt.2024.17.2.286.

Are TERT Promoter Mutations a Poor Prognostic Factor in Anaplastic Thyroid Carcinoma?

• Ryu HJ
• Oh YL
• Heo J
• Park H
• Kim TH
• Kim SW
• Chung JH

• KMID: 2561609
• DOI: http://doi.org/10.11106/ijt.2024.17.2.286

Abstract

Background and Objectives
Telomerase reverse transcriptase (TERT) promoter mutations are a poor prognostic factor in differentiated thyroid carcinoma (DTC). However, their prognostic value in anaplastic thyroid carcinoma (ATC) is unclear. Therefore, we investigated whether TERT promoter mutations also act as an independent poor prognostic factor in ATC.
Materials and Methods
We reviewed the medical records of 41 patients with ATC who underwent the TERT promoter mutations test at Samsung Medical Center between November 1995 and December 2022. The aggressive treatment group was defined as patients who underwent surgery, external radiotherapy, and systemic therapy.
Results
Among 41 patients, 15 (36.6%) showed TERT promoter mutations. There only differences in the clinicopathological characteristics between the TERT-mutant and wild-type groups were tumor size and coexistence of DTC. Median tumor size in the TERT-mutant group was 5.1 cm (3.0-11.0), which was significantly larger than that in the wild-type group (4.1 cm, 0.8-8.0, p=0.010). Nevertheless, the TERT-mutant group received relatively more aggressive treatment (53.3% vs. 19.2%, p=0.056), and the overall survival of the TERT-mutant group was longer than that of the wild-type group (9.4 months [0.4-51.5] vs. 7.1 months [0.4-49.5]), but its difference was not significant (p=0.458). In multiple regression analysis, distant metastasis was a significant prognostic factor, but TERT promoter mutation was not.
Conclusion
Unlike in DTC, TERT promoter mutations were not an independent poor prognostic factor in ATC.

Keyword

TERT promoter mutations; Anaplastic thyroid carcinoma; Undifferentiated thyroid carcinoma; Prognosis

Figure

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  Fig. 1 Overall survival for all 41 patients with anaplastic thyroid carcinoma. The 1-year, 2-year, and 3-year overall survival rates were 37.2%, 29.0%, and 18.1%, respectively.

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  Fig. 2 Overall survival of the TERT-mutant group compared to the wild-type group. The median overall survival of the TERT-mutant group was 9.4 months (range, 0.4-51.5), which is longer than the 7.1 months (0.4-49.5) of the wild-type group. The difference in overall survival between the TERT-mutant group and the TERT wild-type group was not significant (p=0.458).

Reference

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