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Tertiary Healthcare System

Tertiary Healthcare System

Specialized care provided over an extended period is called tertiary care. Usually, a primary or secondary care physician will refer a patient to tertiary care. A patient's maximum physical and mental function is restored in tertiary care, which is caused due to the impact of a chronic illness or condition. Tertiary care aims to achieve the highest level of functioning possible while managing chronic illness. For example, a patient who falls and fractures their hip will need secondary care to...

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Computer-Aided Three-Dimensional Visualization in the Treatment of Locally Advanced Thyroid Cancer

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A third evaluation of tertiary cytoreduction.

Murat Gultekin¹, Melih Velipaşaoğlu, Guldeniz Aksan

¹Department of Obstetrics and Gynecology, Cankiri Government Hospital, Cankiri, Turkey. mrtgultekin@yahoo.com

Journal of Surgical Oncology

|October 22, 2008

Summary

Tertiary cytoreductive surgery (TCS) for ovarian cancer may not improve patient survival. Clinical factors did not predict optimal surgical outcomes in this retrospective study.

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Area of Science:

Gynecologic Oncology
Surgical Oncology

Background:

Recurrent epithelial ovarian carcinoma presents a challenge in treatment.
Tertiary cytoreductive surgery (TCS) is an option for selected patients with recurrent disease.

Purpose of the Study:

To evaluate the impact of tertiary cytoreductive surgery (TCS) on patient survival.
To identify predictors of optimal TCS in recurrent epithelial ovarian carcinoma.

Main Methods:

Retrospective review of 20 patients who underwent TCS for recurrent epithelial ovarian carcinoma between 1992 and 2004.
Analysis of surgical outcomes, including residual disease, morbidity, and survival.

Main Results:

Optimal TCS ( <2 cm residual disease) was achieved in 12 patients; suboptimal in 8.
No macroscopic residual disease in 7 patients, <2 cm in 5, and >=2 cm in 8.
Multivariate analysis did not identify significant predictors for optimal TCS or patient survival.

Conclusions:

Tertiary cytoreductive surgery (TCS) may not significantly improve survival in recurrent epithelial ovarian carcinoma.
No clinical factors were found to predict optimal TCS.
Larger studies are required to draw definitive conclusions.