TERT promoter Mutation and Its Association with Clinicopathological Features and Prognosis of Papillary Thyroid Cancer: A Meta-analysis

We performed a meta-analysis to elucidate the associations of the clinicopathological characteristics and prognostic factors of papillary thyroid cancer (PTC) with TERT promoter mutations. A literature search was performed of the PubMed and EMBASE databases using Medical Subject Headings and keywords. Individual study-specific odds ratios (ORs) and confidence intervals (CIs) were calculated. The average prevalence rate of TERT promoter mutations was 10.1%. TERT promoter mutations occurred more frequently in patients with larger tumors (p = 0.003). TERT promoter mutations were associated with advanced stage (OR = 3.11, 95% CI = 2.22-4.36), lymph node metastasis (OR = 1.82, 95% CI = 1.12-2.96), distant metastasis (OR = 4.18, 95% CI = 1.61-10.81), BRAF mutation positivity (OR = 2.71, 95% CI = 1.45-3.24), recurrence (OR = 3.91, 95% CI = 1.83-8.34), and mortality (OR = 8.13, 95% CI = 3.77-17.53). The associations of TERT promoter mutations with extrathyroidal invasion (OR = 1.98, 95% CI = 0.96-4.07), unifocality (OR = 1.36, 95% CI = 0.90-2.07), and vascular invasion (OR = 1.45, 95% CI = 0.92-2.30) were not significant. TERT promoter mutations are closely associated with aggressive clinicopathological characteristics and poorer prognosis in PTC.