Highlight
– The prevalence of TERT promoter variants increases significantly with patient age in papillary thyroid carcinoma (PTC), being rare under 30 years and common over 65 years.
– In patients younger than 55 without TERT mutations, disease-specific survival (DSS) at 10 years approaches 100%.
– Among patients 55 years or older, those with TERT promoter variants have a markedly worse 10-year DSS (51%) compared to TERT wild-type (91%).
– TERT promoter mutational status independently predicts prognosis beyond conventional age and tumor-node-metastasis (TNM) staging, suggesting potential to enhance risk stratification.