Management of ascites due to gastrointestinal malignancy.
Ascites is the pathological accumulation of fluid within the abdominal cavity. The most common cancers associated with ascites are adenocarcinomas of the ovary, breast, colon, stomach and pancreas. Symptoms include abdominal distension, nausea, vomiting, early satiety, dyspnea, lower extremity edema, weight gain and reduced mobility. There are many potential causes of ascites in cancer patients, including peritoneal carcinomatosis, malignant obstruction of draining lymphatics, portal vein thrombosis, elevated portal venous pressure from cirrhosis, congestive heart failure, constrictive pericarditis, nephrotic syndrome and peritoneal infections. Depending on the clinical presentation and expected survival, a diagnostic evaluation is usually indicated as it will impact both prognosis and the treatment approach. Key tests include serum albumin and protein and a simultaneous diagnostic paracentesis, checking ascitic fluid, WBCs, albumin, protein and cytology. Median survival after diagnosis of malignant ascites is in the range of 1 to 4 months; survival is apt to be longer for ovarian and breast cancers if systemic anti-cancer treatments are available.
Saif
Muhammad W
MW
Department of Medical Oncology, Yale University School of Medicine, New Haven, Connecticut, USA. wasif.saif@yale.edu
Siddiqui
Imran A P
IA
Sohail
Muhammad A
MA
D000230:Adenocarcinoma / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D000818:Animals; D001201:Ascites / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D002986:Clinical Trials as Topic; D006801:Humans; D009369:Neoplasms / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D011379:Prognosis; D015996:Survival Rate; D013997:Time Factors
Cancer. 1993 Mar 15;71(6):2027-30
7680276
Am J Clin Oncol. 1982 Apr;5(2):167-72
6178284
Br Med J (Clin Res Ed). 1984 Mar 10;288(6419):749-51
6423061
Anticancer Res. 1995 Sep-Oct;15(5B):2201-6
8572625
Cancer. 1985 May 1;55(9):1973-8
3978577
Br J Surg. 1982 Aug;69(8):441-2
7049306
Br J Surg. 1996 Jan;83(1):6-14
8653366
Palliat Med. 2002 May;16(3):213-8
12046997
N Z Med J. 1997 Feb 14;110(1037):33-5
9066565
QJM. 2008 Feb;101(2):71-85
18184668
N Engl J Med. 1994 Feb 3;330(5):337-42
8277955
Ann Intern Med. 1990 Jun 15;112(12):889-91
2187389
Adv Intern Med. 1990;35:365-73
2405598
Ital J Gastroenterol Hepatol. 1999 Oct;31(7):626-34
10604107
J Pain Symptom Manage. 1998 Aug;16(2):96-101
9737100
Cancer. 1984 Nov 15;54(10):2226-30
6207907
Hepatology. 1996 Jan;23(1):164-76
8550036
Arch Intern Med. 2001 Dec 10-24;161(22):2733-7
11732940
J Gastroenterol Hepatol. 2007 Dec;22(12):2161-6
18031375
Int J Oncol. 2000 Mar;16(3):445-54
10675474
Ann Surg Oncol. 2007 Aug;14(8):2348-57
17505860
Arch Intern Med. 1979 Feb;139(2):235
434979
Palliat Med. 1999 Sep;13(5):429-30
10659116
Medsurg Nurs. 1995 Dec;4(6):468-71
8696395
Eur J Cancer. 2006 Mar;42(5):589-97
16434188
Gynecol Oncol. 1998 Dec;71(3):381-5
9887235
Hepatology. 2003 Jul;38(1):258-66
12830009
Ann Surg. 1986 Jun;203(6):644-51
3718029
Gastroenterology. 1992 Oct;103(4):1302-6
1397889
Hepatology. 1985 May-Jun;5(3):403-7
3888808
Palliat Med. 2000 Jan;14(1):62-4
10717726
Eur J Cancer. 1991;27(2):121-5
1827272
Anticancer Res. 2006 Jan-Feb;26(1B):709-13
16739342
Hepatology. 1988 Sep-Oct;8(5):1104-9
3417231
Clin Cancer Res. 1996 Jul;2(7):1207-14
9816289
J Surg Oncol. 1982 Aug;20(4):238-42
6180252
Gynecol Oncol. 1992 Oct;47(1):102-9
1427388
Br J Surg. 1983 Aug;70(8):478-81
6871638
Cancer Treat Rev. 1985 Dec;12 Suppl B:23-32
3833327
Am J Pathol. 1998 Oct;153(4):1249-56
9777956
N Engl J Med. 2004 Apr 15;350(16):1646-54
15084697
Eur J Surg Oncol. 1996 Jun;22(3):237-9
8654603
J Gastroenterol Hepatol. 1992 Mar-Apr;7(2):161-4
1571498
Clin Cancer Res. 1998 Aug;4(8):1899-902
9717817
J Nippon Med Sch. 2007 Oct;74(5):355-8
17965529
Surgery. 1974 Feb;75(2):299-304
4590763
Diagn Cytopathol. 2005 Nov;33(5):300-8
16240400
Gastrointest Endosc. 2006 Dec;64(6):908-13
17140897
Ann Surg Oncol. 1994 Sep;1(5):378-81
7531600
Am J Hosp Pharm. 1994 May 1;51(9):1184-92
8042637