Clinicopathological characteristics and prognosis of gastric cancer with malignant ascites

Abstract

Management of gastric cancer with malignant ascites is a challenge, and limited data are available. We evaluated factors affecting survival for this condition to determine factors that predict survival outcome and to develop a rational treatment plan. We retrospectively studied 5,542 patients with gastric adenocarcinoma from January 2007 to December 2012. Among them, 347 patients (6.26%) were associated with malignant ascites. The patients' overall survival was compared among the different features. Three hundred forty-seven patients (153 females and 194 males; median age, 53 years) were enrolled, including 78 (22.5%) young patients and 63 (18.1%) elderly patients. One hundred forty-three (41.2%) patients presented with malignant ascites at the initial diagnosis of gastric cancer, and 211 (60.8%) received chemotherapy. After a median follow-up duration of 10.4 months, the median survival after the diagnosis of malignant ascites was 5.2 months (95% CI, 4.8-5.6 months), and the 1-year survival rate was 16.1 %. An ECOG score greater than 2 (P < 0.001), the presence of ascites with the diagnosis of gastric cancer (P < 0.001), no chemotherapy (P < 0.001), an albumin level less than 30 g/L (P = 0.013), an ascites volume greater than 2,000 mL (P = 0.019), Helicobacter pylori infection (P = 0.010), and metastases to other organs (P = 0.037) were associated with poor prognosis, and they were all independent prognostic factors. The survival of gastric cancer patients with malignant ascites is relatively short, and ECOG score and the presence of ascites with the diagnosis of gastric cancer are the most important prognostic factors. Additionally, chemotherapy could improve the overall survival.

Pancreas Adenocarcinoma: Ascites, Clinical Manifestations, and Management Implications

“…We present very detailed characteristics of a cohort of 180 patients, and our results correlate with smaller prior studies 7,8,25,28–30 that show that ascites is a late manifestation of advanced pancreatic adenocarcinoma, and its presence carries an ominous prognosis, with observed mean OS in our cohort being 12 months (range, 10–14 months [95% CI]) from diagnosis and 1.8 months (range, 1.6–2.3 months [95%CI]) OS after ascites developed. Patients who presented with metastatic disease developed ascites 7 months following diagnosis.…”

“…Prior studies have evaluated malignant ascites in different types of cancers, 7,8,25,28–30 but very limited data exist on the prognostic importance of malignant ascites in pancreas adenocarcinoma. We present very detailed characteristics of a cohort of 180 patients, and our results correlate with smaller prior studies 7,8,25,28–30 that show that ascites is a late manifestation of advanced pancreatic adenocarcinoma, and its presence carries an ominous prognosis, with observed mean OS in our cohort being 12 months (range, 10–14 months [95% CI]) from diagnosis and 1.8 months (range, 1.6–2.3 months [95%CI]) OS after ascites developed.…”

Diagnostic and prognostic value of circulating miR-18a in the plasma of patients with gastric cancer

“…Gastric cancer is the fourth most common malignant tumors around the world and the second leading cause of death related to cancer worldwide [1]. Approximately 21,320 new cases of gastric cancer were diagnosed in 2012 in the USA, which accounted for roughly 10,540 deaths [2].…”

“…Therefore, the improvements of early detection and prognosis evaluation will greatly benefit the patients with gastric cancer by the conduction of early surgery and proper management after operation for patients with high-risk recurrence. Unfortunately, there is insufficient sensitivity and specificity to facilitate the early detection of the conventional serum markers, such as carcinoembryonic antigen and carbohydrate antigen 19-9 [1]. And, accurate clinical prognosis and reliable risk-adjusted decision are hard to be made based on the current prognosticators, such as tumor grade, stage, size, and so on.…”

Successful Long-term Management with a Single Administration of Tri-weekly Nab-paclitaxel in a Patient with Advanced Gastric Cancer with Peritoneal Dissemination

“…Generally, malignant ascites in various cancers are associated with a poor prognosis (6). Indeed, the median overall survival is only 3 to 4 months when AGC patients with malignant ascites do not receive any chemotherapy (7). The single administration of nab-paclitaxel appeared to be quite effective, as he survived more than 1.5 years from its administration.…”