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Background: reliable prognostic factors of lymph node metastasis 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 metastasis in patients oper- ated on for differentiated thyroid carcinoma.
Setting: private practice.
Design: retrospective observational.
Population: 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 metastasis.
Method: review of clinical records and pathological reports.
Results: 145 patients (22.7 %) had histologically positive lymph nodes. Multivariate analysis showed that less than 45 years (p = 0.001), palpable adenopathy (p = 0.0001), multicentricity (p = 0.005) and extracapsular invasion (p = 0.0001) were independent risk factors of lymph node metastasis. These factors, together, had high specificity (97 %) but low sensibility (40 %). Metastasis in jugular lymph nodes with normal central nodes (skip metastasis) was found in 29 (5.54 %) cases.
Conclusions: even though some of the factors studied proved to be of prognostic value, additional variables are needed to better define surgical management.
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