GIST-related malignant ascites with large-volume paracentesis complicated by myocardial infarction and tumour rupture

Hacking, Sadé; Jackson, Karl; Johnston, Robert; Grogan, Eleanor; Walmsley, Rowan; Armstrong, Leonie; Coleman, Joanna; Grieve, Jennifer; Robinson, Sarah; Frew, Katie; Aujayeb, Avinash

doi:10.1136/bmjspcare-2020-002506

Cited by 2 publications

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“…Frequent high-dose drainage reportedly increases the frequency of hemodynamic instability (eg, hypotension and renal dysfunction). 10 , 16 , 18 Accordingly, the amount of ascites drainage may be reduced. This is also more likely to occur in small Japanese patients in comparison to Westerner patients, and the clinical guideline for gastrointestinal symptoms in cancer patients in Japan 19 suggests that 1000–3000 mL can be safely drained.…”

Section: Introductionmentioning

confidence: 99%

Is Low Volume Drainage of Ascites Associated With Improved Survival in Digestive System Cancer Patients With Malignant Ascites?—A Retrospective Cohort Study

et al. 2023

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Objectives: To determine whether the volume of paracentesis for malignant ascites in acute care hospital wards is associated with survival and symptom relief. Methods: Patients with malignant ascites caused by digestive system cancer who underwent paracentesis between January 2010 and April 2022 were retrospectively analyzed from medical records. Collected data included the drainage volume per paracentesis procedure, survival time from the first paracentesis procedure, symptoms, and adverse events. According to the volume per paracentesis procedure, we divided the patients into the “small-drainage” (≤1500 mL) and “standard-drainage” (>1500 mL) groups. Results: The median age of the 144 patients was 69 years, 33% were female, and 64% had gastrointestinal cancer. The median survival from the first paracentesis procedure was 36 days. Eighty-nine (61.8%) and 55 (38.2%) patients were allocated to the small-drainage and standard-drainage groups, respectively. The median number of paracentesis procedures in the small-drainage and standard-drainage groups was 12 and 7, respectively ( P=.001). The median survival in the small-drainage and standard-drainage groups was 50 and 44 days, respectively ( P=.76). The multivariate analysis showed that the amount of drainage per session was not significantly associated with survival. Symptoms improved similarly in the 2 groups. No serious adverse events were observed. Conclusions: Paracentesis was demonstrated to be effective and safe, irrespective of the amount of fluid drained, for patients with malignant ascites in an acute care hospital. Thus, a strategy of limiting the amount of drainage is not associated with longer survival.

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Section: Introductionmentioning

confidence: 99%

Is Low Volume Drainage of Ascites Associated With Improved Survival in Digestive System Cancer Patients With Malignant Ascites?—A Retrospective Cohort Study

et al. 2023

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Factors associated with gastrointestinal stromal tumor rupture and pathological risk: A single-center retrospective study

Liu,

Jia,

Sun

2023

World J Radiol

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BACKGROUND Gastrointestinal stromal tumor (GIST) is a rare gastrointestinal mesenchymal tumor with potential malignancy. Once the tumor ruptures, regardless of tumor size and mitotic number, it can be identified into a high-risk group. It is of great significance for the diagnosis, treatment, and prognosis of GIST if non-invasive examination can be performed before surgery to accurately assess the risk of tumor. AIM To identify the factors associated with GIST rupture and pathological risk. METHODS A cohort of 50 patients with GISTs, as confirmed by postoperative pathology, was selected from our hospital. Clinicopathological and computed tomography data of the patients were collected. Logistic regression analysis was used to evaluate factors associated with GIST rupture and pathological risk grade. RESULTS Pathological risk grade, tumor diameter, tumor morphology, internal necrosis, gas-liquid interface, and Ki-67 index exhibited significant associations with GIST rupture (P < 0.05). Gender, tumor diameter, tumor rupture, and Ki-67 index were found to be correlated with pathological risk grade of GIST (P < 0.05). Multifactorial logistic regression analysis revealed that male gender and tumor diameter ≥ 10 cm were independent predictors of a high pathological risk grade of GIST [odds ratio (OR) = 11.12, 95% confidence interval (95%CI): 1.81-68.52, P = 0.01; OR = 22.96, 95%CI: 2.19-240.93, P = 0.01]. Tumor diameter ≥ 10 cm, irregular shape, internal necrosis, gas-liquid interface, and Ki-67 index ≥ 10 were identified as independent predictors of a high risk of GIST rupture (OR = 9.67, 95%CI: 2.15-43.56, P = 0.01; OR = 35.44, 95%CI: 4.01-313.38, P < 0.01; OR = 18.75, 95%CI: 3.40-103.34, P < 0.01; OR = 27.00, 95%CI: 3.10-235.02, P < 0.01; OR = 4.43, 95%CI: 1.10-17.92, P = 0.04). CONCLUSION Tumor diameter, tumor morphology, internal necrosis, gas-liquid, and Ki-67 index are associated with GIST rupture, while gender and tumor diameter are linked to the pathological risk of GIST. These findings contribute to our understanding of GIST and may inform non-invasive examination strategies and risk assessment for this condition.

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GIST-related malignant ascites with large-volume paracentesis complicated by myocardial infarction and tumour rupture

Cited by 2 publications

References 2 publications

Is Low Volume Drainage of Ascites Associated With Improved Survival in Digestive System Cancer Patients With Malignant Ascites?—A Retrospective Cohort Study

Is Low Volume Drainage of Ascites Associated With Improved Survival in Digestive System Cancer Patients With Malignant Ascites?—A Retrospective Cohort Study

Factors associated with gastrointestinal stromal tumor rupture and pathological risk: A single-center retrospective study

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