Factores predictores de metástasis ganglionar en el carcinoma diferenciado de tiroides

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.