Sex and Mortality Among Patients with Papillary Thyroid Cancer
Authors' conclusion
This cohort study reconciled previous controversies on the prognostic value of patient sex and establishes male sex as a cardinal mortality risk in PTC in a patient age- and tumor genetic-dependent manner, defining especially male patients aged 45 years and older with dual BRAF V600E and TERTp mutations as having the worst prognosis
Study context
- Population
- Patients with papillary thyroid cancer (PTC) treated at 15 centers in 10 countries, 1979–2023; median (IQR) age 48 (37–59) years, 76.1% women
- Participants
- 4,746 patients
- Exposure
- Male vs female patients with PTC
- Malen = 1,134
- Femalen = 3,612reference
- Outcome
- PTC-specific mortality (deaths specifically caused by PTC)
- Follow-up
- Median (IQR) 51.0 (26.4-109.1) months
Methodological details15 centers in 10 countries
- 15 centers in 10 countries
Main finding
As reported in the abstract
Overall PTC-specific mortality
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| PTC-specific mortality, patients aged ≥45 years with dual BRAF V600E and TERTp mutationsAdjusted for clinicopathologic factors | 3.07 (1.35–6.97) | P = 0.007 | |
| 0.10.31310Hazard ratio (log scale) |
- PTC-specific mortality, patients aged ≥45 years with dual BRAF V600E and TERTp mutations — Male sex-age synergy index
- 1.81 (95% CI 1.02-3.16)
PTC-specific mortality by BRAF V600E/TERTp mutation status
- Male sex-associated risk observed only in patients with BRAF V600E or TERTp mutations, not wild-type genes
- Mortality paralleled occurrence and accumulation of dual BRAF V600E and TERTp mutations, with age-dependent rise prominent from around age 45 years, markedly amplified by male sex
Original publication
Sex and Mortality Among Patients with Papillary Thyroid Cancer. JAMA Netw Open. Published 1 September 2026. doi:10.
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