Mirian C, Duun-Henriksen AK, Juratli T, et al. - Since TERT gene alterations (TERT-alt) were associated with increased risk of recurrence in meningiomas, researchers sought to examine the relationship to mortality. Because there is an incongruity between the clinical course and the WHO grade, reliable biomarkers were pursued. Data were gathered from eight studies and allocated patients to TERT-alt (n = 59) or TERT promoter wild-type (TERTp-wt; n = 618). They estimated the impacts of WHO grade, age at diagnosis and sex as HRs. Data reported that TERT-alt occurred in 4.7%, 7.9%, and 15.4%, respectively, of WHO-I/WHO-II/WHO-III meningiomas. Compared with WHO-III TERTp-wt patients, the mortality rate was 2.7 times higher in the WHO-I and WHO-II TERT-alt patients. For a significantly higher risk of recurrence and death in meningiomas, TERT-alt is an important biomarker and it should be managed and surveilled aggressively. They suggest that the TERT-alt analysis be introduced in meningioma as a routine diagnostic test and be incorporated into the WHO classification.