title: [Pathogenesis and management of refractory malignant ascites].
abstract: Malignant ascites are the cancer-associated accumulation of fluids in the peritoneal cavity. The neoplasms most frequently associated with ascites are ovarian, breast, colon, stomach and pancreas adenocarcinomas. Symptoms are abdominal distention, nausea, vomiting, anorexia, dyspnea and limbs oedemas. Several pathophysiological mechanisms might be implicated such as peritoneal carcinomatosis, lymphatic vessels' obstruction, portal hypertension or heart failure. Its diagnosis is most often performed in a context of already known neoplasia. Malignant ascites are associated with a pejorative evolution. Ascites which cannot be mobilized or show early recurrence and cannot be prevented by medical treatment are defined as refractory ascites. Therefore, management of refractory malignant ascites takes place in the context of palliative care and aims at improving the quality of life of these patients. This review lists the current data reported on the pathophysiology of malignant ascites and describes the present and future options for refractory malignant ascites management.
authors.affiliation: Centre Antoine-Lacassagne, département d’oncologie médicale, Nice, France. saadaesma@gmail.com
authors.forename: Esma
authors.initials: E
authors.lastname: Saâda
authors.forename: Philippe
authors.initials: P
authors.lastname: Follana
authors.forename: Fréderic
authors.initials: F
authors.lastname: Peyrade
authors.forename: Véronique
authors.initials: V
authors.lastname: Mari
authors.forename: Eric
authors.initials: E
authors.lastname: François
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D001201:Ascites / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D001943:Breast Neoplasms / Q000150:complications; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D007274:Injections, Intraperitoneal; D008175:Lung Neoplasms / Q000150:complications; D008297:Male; D058990:Molecular Targeted Therapy / Q000379:methods; D010051:Ovarian Neoplasms / Q000150:complications; D010166:Palliative Care; D019152:Paracentesis / Q000379:methods; D010529:Peritoneal Cavity / Q000503:physiopathology; D010536:Peritoneovenous Shunt / Q000379:methods; D011788:Quality of Life; D012008:Recurrence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D000970:Antineoplastic Agents; D004232:Diuretics; D042461:Vascular Endothelial Growth Factor A