Malignant Ascites attributable to portal hypertension usually is associated with an increased serum ascites-albumin gradient (> 1.1 g/dL), a variable total protein, and negative ascitic cytology. Ascites caused by peritoneal carcinomatosis does not respond to diuretics.
Patients may be treated with periodic large-volume paracentesis for symptomatic relief. Intraperitoneal chemotherapy is sometimes used to shrink the tumor, but the overall prognosis is extremely poor, with only 10% survival at 6 months. Ovarian cancers represent an exception to this rule. With newer treatments consisting of surgical debulking and intraperitoneal chemotherapy, long-term survival from ovarian cancer is possible.
Malignant ascites is a manifestation of advanced malignant disease that is associated with significant morbidity. Although lymphatic obstruction has been considered the major pathophysiologic mechanism behind its formation, recent evidence suggests that immune modulators, vascular permeability factors, and metalloproteinases are contributing significantly to the process. The mean survival in patients with malignant ascites is usually less than 4 months. These new observations offer the opportunity for development of new, more targeted therapies for the treatment of malignant ascites. Therefore therapy has concentrated on symptom control. Approaches have included sodium restricted diets, diuretics, serial paracentesis, peritoneal shunting and chemotherapy (systemic and intraperitoneal).
Malignant ascites is seen most commonly in patients with ovarian, endometrial, breast, colon, gastric, and pancreatic cancer. It has been shown that around 10 to 15% of all patients with gastrointestinal cancer develop ascites at some stage of their disease. Generally, the presence of malignant ascites is associated with poor prognosis, regardless of the cause. The diagnosis and management of this challenging medical problem are subsequently discussed, with emphasis on how these new pathophysiologic insights are being applied to the development of novel therapies that may soon change how we manage this troubling clinical condition.
Causes of Malignant Ascites
Here are the list of the possible Causes of Malignant Ascites:
Symptoms of Malignant Ascites
Some sign and Symptoms related to Malignant Ascites:
Treatment of Malignant Ascites
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