Previous studies have reported that TERT promoter mutations were significantly associated with poor prognoses, such as tumor aggressiveness, early recurrence, and cancer-specific death [3]. However, the real-world frequency of TERT promoter mutations was unclear before Kim et al. [4] first reported it in Korea in 2020. Furthermore, in a letter to the editor, Kim et al. [4] provided data from a meta-analysis, which constituted valuable findings that could help us understand TERT promoter mutations more precisely.

According to the meta-analysis data, the frequency of TERT promoter mutation in a prospective cohort in Korea was lower than expected (2.6% in all PTCs, 1.3% in PTCs ≤1.0 cm, and 5.6% in PTCs >1.0 cm). Although the real-world frequency was low, the clinicopathological characteristics associated with TERT promoter mutations, such as older age, larger size, and tumor aggressiveness, were consistent with the previous report [3]. We appreciate Kim et al. for providing interesting data.

Kim et al. [5] also pointed out that the role of TERT promoter mutations in PTCs ≤1 cm is unclear. We previously reported that TERT promoter mutations can be a molecular prognostic marker in thyroid carcinoma, but we agree that this may not be the case in PTCs ≤1 cm. Future studies with long-term follow-up would be needed to provide solid evidence.

We deeply appreciate the valuable comments of Dr. Kim and colleagues and their work that enriched the findings of our research.