Treatment of Malignant Ascites

Chung, Michael; Kozuch, Peter

doi:10.1007/s11864-008-0068-y

Cited by 77 publications

(57 citation statements)

References 59 publications

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“…Endostar reduces peritoneal permeability. Angiogenesis and vessel hyperpermeability are two important factors involved in ascites formation (1)(2)(3)(4)(5)17). The peritoneal permeability assay is used to determine vessel permeability in animal models (18,19).…”

Section: Resultsmentioning

confidence: 99%

“…spread of tumor cells. Ascites can occur in a variety of cancers, including ovarian (37%), pancreaticobiliary (21%), gastric (18%), esophageal (4%), colorectal (4%) and breast (3%) cancer (1)(2)(3). Ascites may result in a poor quality of life due to symptoms of abdominal distention, pain, nausea, vomiting, anorexia, dyspnea, limb edema, insomnia and fatigue (1)(2)(3).…”

Section: Introductionmentioning

confidence: 99%

“…The i.p. administration of radioisotopes, or chemotherapy and peritoneovenous shunting procedures, has also been used (3,4). However, data regarding these approaches is also lacking.…”

Section: Introductionmentioning

confidence: 99%

“…These methods are able to relieve the symptoms of recurrent ascites, but do not prolong survival (4). Repeated paracentesis is associated with regular hospital admissions and can lead to a number of problems, including pain, protein loss, hypovolemia, infection, peritonitis and bowel perforation (3,4). The preclinical and clinical evidence concerning anti-angiogenic agents, such as vascular endothelial growth factor (VEGF) antagonists and matrix metalloproteinase inhibitors, suggest that these agents may have a role in the treatment of malignant ascites (5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

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Endostar inhibits ascites formation and prolongs survival in mouse models of malignant ascites

et al. 2015

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Abstract. Endostar, a modified recombinant human endostatin, inhibits the growth of a variety of tumors by suppressing neovascularization. Vascular endothelial growth factor (VEGF) has an important role in malignant ascites formation. In order to determine whether Endostar can suppress the formation of ascites and prolong survival times, mouse models of malignant ascites were established using S180 and H22 tumor cells. The experimental mice were randomly divided into four groups: The three treatment groups received different doses of Endostar (4, 8 and 16 mg/kg), and the control group received 0.9% w/v NaCl. The volume of ascites, and the tumor cell, red blood cell (RBC), VEGF protein and mRNA content of the ascites was measured alongside the peritoneal permeability and the mouse survival time. In vitro analysis of cultured Endostar-treated S180 and H22 cells was also performed in order to examine cellular proliferation and the level of VEGF secreted protein and mRNA. The results revealed that Endostar suppressed the ascites volume, decreased the level of tumor cells, RBCs and VEGF in the ascites fluid, and lowered the permeability of the peritoneum. The tumor cells collected from the ascites in the Endostar-treated mice demonstrated a decrease in the expression of VEGF mRNA. The survival rates of the 8 and 16 mg/ kg Endostar-treated mice were longer than those of the controls. The in vitro experiments revealed a significant inhibition of VEGF protein secretion and VEGF mRNA by Endostar, but no effect on cellular proliferation. In conclusion, Endostar lowers ascites production by downregulating VEGF expression, and may therefore be effective for the treatment of malignant ascites. IntroductionMalignant ascites is caused by the accumulation of fluid in the peritoneal cavity following the intraperitoneal (i.p.) spread of tumor cells. Ascites can occur in a variety of cancers, including ovarian (37%), pancreaticobiliary (21%), gastric (18%), esophageal (4%), colorectal (4%) and breast (3%) cancer (1-3). Ascites may result in a poor quality of life due to symptoms of abdominal distention, pain, nausea, vomiting, anorexia, dyspnea, limb edema, insomnia and fatigue (1-3).Chemotherapy is a common first-line treatment for patients with ascites. However, limited evidence exists concerning its efficacy in patients with recurrent ascites. The i.p. administration of radioisotopes, or chemotherapy and peritoneovenous shunting procedures, has also been used (3,4). However, data regarding these approaches is also lacking. These methods are able to relieve the symptoms of recurrent ascites, but do not prolong survival (4). Repeated paracentesis is associated with regular hospital admissions and can lead to a number of problems, including pain, protein loss, hypovolemia, infection, peritonitis and bowel perforation (3,4). The preclinical and clinical evidence concerning anti-angiogenic agents, such as vascular endothelial growth factor (VEGF) antagonists and matrix metalloproteinase inhibitors, suggest that these agents may have...

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The i.p. administration of radioisotopes, or chemotherapy and peritoneovenous shunting procedures, has also been used (3,4). However, data regarding these approaches is also lacking.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Endostar inhibits ascites formation and prolongs survival in mouse models of malignant ascites

et al. 2015

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“…This procedure is usually performed in patients with a life expectancy of more than 2 to 3 months. 14 If the patient continues to experience symptoms of nausea, prokinetic agents, dopamine antagonists, and corticosteroids can he helpful. 9 Gastric cancer is rare in the United States and often presents at a late stage.…”

Section: Discussionmentioning

confidence: 99%

84-Year-Old Man With Respiratory Distress and Abdominal Distention

Pachman

Morrison

Szostek

2011

Mayo Clinic Proceedings

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A n 84-year-old man presented to his local hospital after falling from his wheelchair. He had tachypnea and abdominal distention. Chest radiography revealed a rightsided pleural effusion, and abdominal radiography showed dilated loops of bowel, suggestive of bowel obstruction. The patient was then transferred to our hospital for further work-up.The patient reported worsening of shortness of breath and abdominal distention for the past few weeks. He had a 1-year history of early satiety, nausea, and dyspepsia but had noted no weight loss. The patient was taking omeprazole for peptic ulcer disease. Recently, after positive findings on a urea breath test, metronidazole and clarithromycin were initiated for treatment of Helicobacter pylori. The patient's medical history also included type 2 diabetes, benign prostatic hyperplasia, and hypertension for which he was taking aspirin, glipizide, lisinopril, and finasteride. He was a former smoker who had quit 50 years ago.Physical examination revealed the following: temperature, 36.4° C; blood pressure, 108/58 mm Hg; regular pulse rate, 103 beats/min; respiratory rate, 26 breaths/min; and oxygen saturation of 93% while breathing 3 L of oxygen. The patient was visibly tachypneic, with diffuse expiratory wheezing and decreased breath sounds in the right base. His abdomen was distended with bulging flanks and a positive fluid wave.Important laboratory values on admission included the following (reference ranges provided parenthetically): hemoglobin, 10.4 g/dL (13.5-17.5 g/dL); white blood cells, 12.2 x 10 9 /L (3.5-10.5 x 10 9 /L); platelets, 348 x 10 9 /L (150-450 x 10 9 /L); sodium, 134 mEq/L (135-145 mEq/L); bicarbonate, 21 mEq/L (22-29 mEq/L); blood urea nitrogen, 35 mg/dL (8-24 mg/dL); creatinine, 1.5 mg/dL (0.8-1.3 mg/ dL); chloride, 103 mmol/L (100-108 mmol/L); glucose, 160 mg/dL (70-100 mg/dL); aspartate aminotransferase, 15 U/L (17-59 U/L); total bilirubin, 0.3 mg/dL (0.1-1.0 mg/dL); albumin, 2.9 g/dL (3.5-5.0 g/dL); and lactate, 0.78 mmol/L (0.6-2.3 mmol/L).Abdominal computed tomography without contrast medium showed a moderate amount of ascites, moderate right-sided pleural effusion, and a mildly nodular configuration of the liver. Thoracentesis resulted in removal of 1 L of serosanguineous fluid. Pleural fluid lactate dehydrogenase (LDH) was 724 U/L, total protein was 4.1 g/dL, glucose was 121 mg/dL, and pH was 7.7. The total nucleated cell count was 1196 U/L, with differential of neutrophils at 46%, lymphocytes at 5%, monocytes at 2%, and eosinophils at 2%. The serum LDH level was 200 U/L, and the serum protein level, 5.7 g/dL. The first step in the evaluation of the pleural fluid is to determine whether it is a transudate or exudate. On the basis of criteria from Lights et al, 1 an exudate has a pleural fluid protein to serum protein ratio greater than 0.5, pleural fluid LDH to serum LDH greater than 0.6, or pleural fluid LDH greater than two-thirds the upper limit of the laboratory's normal serum LDH level. Fulfilling any of these 3 criteria indicates an exuda...

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Management of drainage for malignant ascites in gynaecological cancer

Keen

Fitzgerald

Bryant

et al. 2009

Cochrane Database of Systematic Reviews

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Background-Most patients with advanced ovarian cancer and some patients with advanced endometrial cancer need repeated drainage for malignant ascites. Guidelines to advise those involved in the drainage of ascites are usually produced locally and are generally not evidencebased but mainly based on clinicians' anecdotal evidence and experience. To discover whether there are ways of managing drains that have been demonstrated to improve the efficacy and quality of the procedure is key in making recommendations which could improve the quality of life (QOL) for women at this critical period of their lives. Objectives-To evaluate the benefit and harms of different practices in the management of drains for malignant ascites in the care of women with advanced or recurrent gynaecological cancer. The review aimed to evaluate the evidence regarding the following questions; How long should the drain stay in place? Should the volume of fluid drained be replaced intravenously? Should the drain be clamped to regulate the drainage of fluid? Should any particular vital observations be regularly recorded? Search methods-We searched the Cochrane Central Register of Controlled Trials (CENTRAL) Issue 1, 2009, Cochrane Gynaecological Cancer Group Trials Register, MEDLINE1950 to February Week 3 2009, Embase 1980 to 2009 Week 8 2009. We also searched registers of clinical trials, abstracts of scientific meetings, reference lists of review articles and contacted experts in the field. Selection criteria-We searched for randomised controlled trials (RCTs), quasi-RCTs and nonrandomised studies that compared a range of interventions for management of multiple

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Treatment of Malignant Ascites

Cited by 77 publications

References 59 publications

Endostar inhibits ascites formation and prolongs survival in mouse models of malignant ascites

Endostar inhibits ascites formation and prolongs survival in mouse models of malignant ascites

84-Year-Old Man With Respiratory Distress and Abdominal Distention

Management of drainage for malignant ascites in gynaecological cancer

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