title: Pancreatic cancer with malignant ascites: clinical features and outcomes.
abstract: OBJECTIVE
  Malignant ascites (MA) caused by peritoneal carcinomatosis is not uncommon in patients with pancreatic cancer. However, the clinical features and outcomes in these patients remain to be elucidated.
  
  
  METHODS
  Baseline characteristics and overall survival (OS) of consecutive patients with advanced pancreatic cancer who presented with MA were retrospectively evaluated.
  
  
  RESULTS
  Of 494 patients with advanced pancreatic cancer, 73 (15%) presented with MA. Patients with synchronous MA (n = 21), compared with those with metachronous MA (n = 52), had better performance status (P = 0.02), smaller amount of ascites (P < 0.01), and higher chance of receiving chemotherapy (57% vs 17%, P < 0.01), and resulted in longer OS (115 vs 42 days, P < 0.01). Overall survival was significantly longer in patients receiving chemotherapy than in those with best supportive care alone (124 vs 50 days, P < 0.01). In a multivariate analysis, chemotherapy was prognostic in addition to performance status, CRP, and small amount of MA; the hazard ratio of chemotherapy was 0.46, compared with best supportive care alone (P = 0.02).
  
  
  CONCLUSIONS
  Although the prognosis of pancreatic cancer patients with MA remains poor, selected patients may be candidate for chemotherapy, regardless of the timing of appearance of MA.
authors: From the Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors: Naminatsu
authors: N
authors: Takahara
authors: Hiroyuki
authors: H
authors: Isayama
authors: Yousuke
authors: Y
authors: Nakai
authors: Takashi
authors: T
authors: Sasaki
authors: Kei
authors: K
authors: Saito
authors: Tsuyoshi
authors: T
authors: Hamada
authors: Suguru
authors: S
authors: Mizuno
authors: Koji
authors: K
authors: Miyabayashi
authors: Dai
authors: D
authors: Mohri
authors: Hirofumi
authors: H
authors: Kogure
authors: Saburo
authors: S
authors: Matsubara
authors: Natsuyo
authors: N
authors: Yamamoto
authors: Kenji
authors: K
authors: Hirano
authors: Hideaki
authors: H
authors: Ijichi
authors: Keisuke
authors: K
authors: Tateishi
authors: Minoru
authors: M
authors: Tada
authors: Kazuhiko
authors: K
authors: Koike
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001201:Ascites / Q000209:etiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D010534:Peritoneal Neoplasms / Q000209:etiology* / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents