Loading Curie Briefs...
Getting the latest healthcare news for you
Getting the latest healthcare news for you
A new study challenges the long-standing use of age cutoffs in thyroid cancer staging, finding that TERT gene variants — not age itself — are the real driver of poor outcomes in papillary thyroid carcinoma. Among older patients with TERT wild-type tumors, 10-year disease-free survival exceeded 90%. The findings point toward a more personalized, genomics-based approach to risk stratification.
For decades, age 55 has been a key dividing line in thyroid cancer staging — but a new study suggests that's the wrong metric. Researchers analyzed 1,555 patients with papillary thyroid carcinoma across three US academic centers and found that TERT promoter variants, not age, are the primary driver of worse survival outcomes. About 82% of the survival disadvantage previously attributed to older age was actually explained by the presence of these genetic variants.
The implications are significant: older patients whose tumors lack TERT variants had 10-year disease-specific survival rates above 91% — comparable to younger patients. Meanwhile, those with TERT variants faced dramatically worse outcomes, with a 12-fold increased risk of disease-specific death in multivariable analysis.
By the Numbers:
Why it matters: These findings call for a rethink of how thyroid cancer is staged and treated. Integrating TERT status into clinical risk frameworks could help clinicians avoid over-treating low-risk older patients and ensure high-risk patients — at any age — get the aggressive care they need.
