Treatment of malignant ascites in patients with advanced cancer: Peritoneovenous shunt versus paracentesis

Seike, Masahiro; Maetani, Iruru; Sakai, Yoshihiro

doi:10.1111/j.1440-1746.2006.04793.x

Cited by 35 publications

(20 citation statements)

References 15 publications

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“…• Patients typically need to be closely monitored with a central venous pressure line for 24 hours after PVS placement. • There are 3 common types of shunts: Hyde, Le Veen, and Denver [26].…”

Section: Peritoneovenous Shuntsmentioning

confidence: 99%

Treatment of Malignant Ascites

Chung

Kozuch

2008

Curr. Treat. Options in Oncol.

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The management of malignant ascites is a significant challenge in gastrointestinal medical oncology. Current treatment strategies include diuretic therapy, paracentesis, peritoneal drains, and venous shunts. However, there are no established evidence-based guidelines, and there is a lack of randomized controlled trials identifying optimal therapy. Newer therapies are emerging and will need further study. By summarizing published studies, this review is intended to add some clarity to currently available strategies for the management of malignant ascites associated with hepatobiliary cancers. Notably, however, much of the available data for the management of malignant ascites comes from the gynecologic oncology experience, specifically from studies in ovarian cancer. Therefore, successful approaches used in this malignancy may be lead candidates for development in hepatobiliary cancer-associated ascites and are reviewed in this paper.

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Section: Peritoneovenous Shuntsmentioning

confidence: 99%

Treatment of Malignant Ascites

Chung

Kozuch

2008

Curr. Treat. Options in Oncol.

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“…Malignant ascites (MA) is an abnormal accumulation of fluid in the peritoneal cavity as a result of cancer,2 and accounts for ~10% of all cases of ascites. It occurs in many malignancies: adrenal, appendiceal, bladder, breast, cervical, colon, endometrial, esophageal, gall bladder, gastric, liver, lung, lymphoma, melanoma, mesothelioma, neuroendocrine, ovarian, pancreatic, renal, testicular, and thyroid 3–11. The most common primary site is epithelial ovarian cancer (EOC), accounting for 38% of MA occurring in females 12.…”

Section: Introductionmentioning

confidence: 99%

Drainage of malignant ascites: patient selection and perspectives

Stukan¹

2017

CMAR

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Malignant ascites (MA) is a sign of advanced cancer and poor prognosis. MA can result in impairment in quality of life (QOL) and significant symptoms. As a supportive treatment, ascites can be drained by paracentesis (PC), percutaneously implanted catheters (tunneled, untunneled, central venous catheters), or peritoneal ports, or peritoneovenous shunts. The aim of this study was to evaluate the effectiveness, safety, and patient-reported outcomes (PRO) of different drainage methods for the management of MA. A systematic review of the literature was performed, and 32 original articles met the inclusion criteria. Patients selected for permanent drain insertion demonstrated symptoms related to MA and had undergone repeated PC. The primary focus of the reviewed articles was procedural safety issues. The rate of technical success of drainage device installation was 100%. Most patients experienced improvements in symptom control after ascites drainage. When analyzed together, 19.7% (255/1297) of patients experienced any complication and 6.2% (81/1297) experienced serious adverse events during MA drainage. Complications were reported for every drainage method; however, the least occurred after PC or central venous catheter, while the most serious occurred after peritoneovenous shunts. Adverse events were as follows: catheter obstruction: 4.4%, infection: 4.1%, leakage: 3.5%, catheter dislodgment: 2.3%, hypotension: 0.6%, injuries during device insertion: 0.6%, renal impairment: 0.5%, electrolyte imbalance: 0.2%, other: 3.6%. PRO and QOL endpoints were available for 12 studies. When PRO were measured using an interview, a significant improvement in symptom control and QOL was reported in almost all patients. Once standardized questionnaires were used, improvements in symptomatic scores and role functioning were observed. Deterioration was observed in cognitive and emotional subscales. MA drainage is a safe and effective method to control symptoms associated with ascites, and should be perceived as a supportive care, that can be applied for those who need it at any time of their cancer trajectory. Patient selection should be performed using a thorough assessment of symptoms and QOL, and should not be delayed.

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“…6 Systemic toxicity 5 is shown by the transitory stimulation of the CNS, and the carcinogenic potential of phenol is disputable, according to those authors. 12 Phenol is mainly eliminated by the kidneys, and most of it is excreted in the first 24 hours.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6] Hence, various substances have been studied (radioactive colloids, immunostimulators, matrix metalloprotease inhibitors and new chemotherapeutic drugs) with or without hyperthermia, which shows the importance of the development of new methods in order to face the challenge of treating neoplastic ascitis. [1][2][3][4][5][6][7][8][9] A literature review indicated that the infusion of a solution composed of phenol, glycerin, and glacial acetic acid into the prostate of dogs led to reduction in that organ's volume 10 , which resulted from tissue necrosis. The use of the solution was experimentally assayed in Walker's tumor hepatic metastases, leading to suggestive results of necrosis production without alterations in the clinical development of the tumor 11 .…”

Section: Introductionmentioning

confidence: 99%

Effects of intraperitoneal injection of phenol, glycerin and acetic acid on neoplastic ascitis in guinea pigs

2008

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PURPOSE: To investigate the histolytic action of a solution composed by phenol, glycerin and acetic acid on neoplastic ascitis in guinea pigs. METHODS: Thirty-two guinea pigs were used. The animals were randomly distributed in experimental and control groups, and the effects of the peritoneal injection of the testing solution were studied. Saline solution was used for the control groups. Biochemical and anatomopathological (heart, lungs, kidneys, spleen and peritoneal serous membrane) were evaluated at 24 hours and 4 weeks of development. RESULTS: It was observed that solution E, when infused into the peritoneal cavity, caused no clinical, histological or laboratory alterations in these animals when compared to those in the control group. CONCLUSION: Given our results, it would be interesting to study the effects of the proposed solution on cases with experimental neoplastic ascites with a later view to treating it in humans.

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Treatment of malignant ascites in patients with advanced cancer: Peritoneovenous shunt versus paracentesis

Abstract: PVS placement provides an effective treatment option for patients with refractory malignant ascites in advanced cancer, and yields a higher likelihood of discharge compared with conventional paracentesis.

Cited by 35 publications

References 15 publications

Treatment of Malignant Ascites

Treatment of Malignant Ascites

Drainage of malignant ascites: patient selection and perspectives

Effects of intraperitoneal injection of phenol, glycerin and acetic acid on neoplastic ascitis in guinea pigs

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