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Revista argentina de cirugía

versión impresa ISSN 2250-639Xversión On-line ISSN 2250-639X


FALCO, Jorge E. et al. Papillary thyroid microcarcinoma. Frequency and risk factors of lymph node metastases. Rev. argent. cir. [online]. 2014, vol.106, n.2, pp.1-10. ISSN 2250-639X.

Background: surgical management of lymph nodes in papillary thyroid microcarcinoma is controver-sial due to its excellent overall prognosis. Objetve: to quantfy the frequency and patern of lymph node metastasis in patents operated on for papillary thyroid microcarcinoma and to identfy predictve factors of regional disease. Seg: private practice. Design: retrospectve, observatonal. Populaton: between June 2002 and June 2012, 434 patents with papillary thyroid microcarcinoma underwent total thyroidectomy and therapeutic neck dissecton only when there was biopsy proved lymph node metastasis. Method: review of clinical records and pathological reports. Results: 66 patents (15.2 %) had histologically positve lymph nodes. Metastasis in jugular lymph no-des with normal central nodes (skip metastasis) was found in 12 (2.76 %) cases. Multvariate analysis showed that less than 45 years (p = 0.02), extracapsular invasion (p = 0.003) and palpable adenopathy (p = 0.001), were independent risk factors of lymph node metastasis. These factors, together, had high specificity (99.7 %) but low sensibility (19.7 %). Conclusions: surgical strategy employed allowed to diagnostic lymph node metastases in both central and lateral compartments; this is of particular importance because even though some of the factors studied proved to be predictve of lack of lymph node metastases, additonal variables are needed to predict presence of regional disease in this subset of thyroid cancer patents.

Palabras clave : papillary thyroid carcinoma, microcarcinoma, lymph node metastasis.

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