Revista argentina de cirugía
versión On-line ISSN 2250-639X
FALCO, Jorge E; OTERO MUNOZ, Alvaro y MONTESINOS, Manuel R. Factores predictores de metástasis ganglionar en el carcinoma diferenciado de tiroides. Rev. argent. cir. [online]. 2012, vol.102, n.2, pp. 57-61. ISSN 2250-639X .
Background: reliable prognostic factors of lymph node metástasis are needed to adapt initial surgical treatment of patients with differentiated thyroid carcinoma. Objetive: to determine the frequency and predictive factors associated with lymph node metástasis in patients operated on for differentiated thyroid carcinoma. Setting: prívate practice. Design: retrospective observational. Popuation: between January 2000 and August 2010, 600 patients with 639 tumours (39 bilateral) underwent total thyroidectomy and therapeutic neck dissection only when there was biopsy proved lymph node metástasis. Method: review of clinical records and pathological reports. Resuts: 145 patients (22.7 %) had histologically positive lymph nodes. Multivariate analysis showed that lessthan 45 years (p = 0.001), palpable adenopathy (p = 0.0001), multicentricity (p = 0.005) and extracapsular invasión (p = 0.0001) were independent risk factors of lymph node metástasis. These factors, together, had high specificity (97 %) but low sensibility (40 %). Metástasis in jugular lymph nodes with normal central nodes (skip metástasis) was found in 29 (5.54 %) cases. Concusions: even though some of the factors studied proved to be of prognostic valué, additional variables are needed to better define surgical management.
Palabras clave : Gland; Thyroid; Neoplasm; Metástasis Lymph node.