Home LiteratureArticle Details
PMID: 18777213 Published · ppublish English Journal Article Review

Treatment of malignant ascites.

Current treatment options in oncology ·Vol. 9 ·No. 2-3 ·2008-06-00 ·Pages 215-33

Chung M, Kozuch P

Abstract

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.

MeSH Terms
Antibodies, Monoclonal Ascites/diagnosis,physiopathology,therapy Clinical Trials as Topic Female Gastrointestinal Neoplasms/diagnosis,physiopathology,therapy Humans Immunotherapy/methods Male Matrix Metalloproteinases/metabolism Medical Oncology/methods Peritoneal Neoplasms/diagnosis,physiopathology,therapy Research Design Treatment Outcome
Chemicals
Antibodies, Monoclonal Matrix Metalloproteinases
Authors & Affiliations
2 authors, click to expand affiliations / ORCID
Chung Michael
Beth Israel Medical Center, New York, NY 10003, USA.
Kozuch Peter
References (74)
74 references, click to expand
  1. Abdominal paracentesis for malignant ascites.
    Arch Intern Med. 1979 Feb;139(2):235 PMID: 434979
  2. Malignant ascites.
    Am J Hosp Palliat Care. 2002 Jan-Feb;19(1):7-8 PMID: 12171427
  3. A rationale for carboplatin treatment and abdominal hyperthermia in cancers restricted to the peritoneal cavity.
    Cancer Res. 1992 Mar 1;52(5):1252-8 PMID: 1737387
  4. Pathogenesis of ascites in peritoneal carcinomatosis.
    Acta Pathol Microbiol Scand. 1953;33(1):10-21 PMID: 13113944
  5. Care of patients with ascites.
    N Engl J Med. 1994 Feb 3;330(5):337-42 PMID: 8277955
  6. Loculation as a contraindication intracavitary 32P-chromic phosphate therapy.
    J Nucl Med. 1975 Apr;16(4):318-9 PMID: 1113189
  7. Intraperitoneal interferon in the management of malignant ascites.
    Cancer. 1993 Mar 15;71(6):2027-30 PMID: 7680276
  8. Treatment of malignant peritoneal effusion in digestive and ovarian cancer.
    Med Oncol Tumor Pharmacother. 1992;9(4):177-81 PMID: 1342062
  9. Intracavitary Corynebacterium parvum for treatment of malignant effusions.
    Gynecol Oncol. 1983 Aug;16(1):6-14 PMID: 6884832
  10. New approach to management of malignant ascites with a streptococcal preparation, OK-432. II. Intraperitoneal inflammatory cell-mediated tumor cell destruction.
    Surgery. 1983 Mar;93(3):365-73 PMID: 6600854
  11. The past, the present and future of the OK-432 therapy for patients with malignant effusions.
    Anticancer Res. 1998 Sep-Oct;18(5D):3917-25 PMID: 9854504
  12. Human leukocyte interferon therapy for advanced ovarian carcinoma.
    Am J Clin Oncol. 1982 Apr;5(2):167-72 PMID: 6178284
  13. Cytoreductive surgery with intraperitoneal hyperthermic chemotherapy for disseminated peritoneal cancer of gastrointestinal origin.
    Am Surg. 2000 Jun;66(6):561-8 PMID: 10888132
  14. A survey of practice in management of malignant ascites.
    J Pain Symptom Manage. 1998 Aug;16(2):96-101 PMID: 9737100
  15. Management of symptomatic malignant ascites with diuretics: two case reports and a review of the literature.
    J Pain Symptom Manage. 1995 Apr;10(3):237-42 PMID: 7629417
  16. Control of malignant ascites by peritoneovenous shunting.
    Cancer. 1984 Nov 15;54(10):2226-30 PMID: 6207907
  17. Treatment of malignant ascites in patients with advanced cancer: peritoneovenous shunt versus paracentesis.
    J Gastroenterol Hepatol. 2007 Dec;22(12):2161-6 PMID: 18031375
  18. Pleurx tunneled catheter in the management of malignant ascites.
    J Vasc Interv Radiol. 2001 Mar;12(3):373-5 PMID: 11287517
  19. Pattern and prognostic factors in patients with malignant ascites: a retrospective study.
    Ann Oncol. 2007 May;18(5):945-9 PMID: 17298959
  20. Laparoscopic intraperitoneal hyperthermic chemotherapy for palliation of debilitating malignant ascites.
    Eur J Surg Oncol. 2006 Aug;32(6):682-5 PMID: 16631341
  21. An assessment of the long-term results of controlling the reaccumulation of malignant effusions using intracavity bleomycin.
    Cancer. 1986 Feb 15;57(4):721-7 PMID: 2417681
  22. Intracavitary administration of radioactive isotopes in the control of effusions due to cancer. Results in 267 patients.
    Cancer. 1966 Aug;19(8):1096-102 PMID: 5912325
  23. The current and future management of malignant ascites.
    Clin Oncol (R Coll Radiol). 2003 Apr;15(2):59-72 PMID: 12708713
  24. Malignant ascites: demographics, therapeutic efficacy and predictors of survival.
    Can J Oncol. 1996 Nov;6(2):474-80 PMID: 12056099
  25. Octreotide as an agent for the relief of malignant ascites in palliative care patients.
    Palliat Med. 1999 Sep;13(5):429-30 PMID: 10659116
  26. Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer.
    J Clin Oncol. 2003 Oct 15;21(20):3737-43 PMID: 14551293
  27. Locoregional immunotherapy of malignant effusion from colorectal cancer using the streptococcal preparation OK-432 plus interleukin-2: induction of autologous tumor-reactive CD4+ Th1 killer lymphocytes.
    Br J Cancer. 2003 Nov 17;89(10):1876-84 PMID: 14612896
  28. A new approach to the management of malignant ascites; a permanently implanted abdominal drain.
    Eur J Surg Oncol. 1990 Feb;16(1):47-53 PMID: 1689678
  29. The effect of volume on the distribution of substances instilled into the peritoneal cavity.
    Gynecol Oncol. 1978 Feb;6(1):106-10 PMID: 413767
  30. Malignant ascites: systematic review and guideline for treatment.
    Eur J Cancer. 2006 Mar;42(5):589-97 PMID: 16434188
  31. Summary of ten years of the use of radioactive colloids in intracavitary therapy.
    J Nucl Med. 1960 Jul;1:195-8 PMID: 13876489
  32. A randomized trial of paracentesis plus intraperitoneal tumor necrosis factor-alpha versus paracentesis alone in patients with symptomatic ascites from recurrent ovarian carcinoma.
    Gynecol Oncol. 1997 Jan;64(1):80-7 PMID: 8995552
  33. Effective relief of malignant ascites in patients with advanced ovarian cancer by a trifunctional anti-EpCAM x anti-CD3 antibody: a phase I/II study.
    Clin Cancer Res. 2007 Jul 1;13(13):3899-905 PMID: 17606723
  34. Mobilization of malignant ascites with diuretics is dependent on ascitic fluid characteristics.
    Gastroenterology. 1992 Oct;103(4):1302-6 PMID: 1397889
  35. Suppression of ascites formation and re-accumulation associated with human ovarian cancer by an anti-VPF monoclonal antibody in vivo.
    Anticancer Res. 2000 Jan-Feb;20(1A):155-60 PMID: 10769648
  36. Management of peritoneal effusions with intracavitary mitoxantrone or bleomycin.
    Anticancer Drugs. 1994 Jun;5(3):305-8 PMID: 7522646
  37. Prospective trial for the treatment of malignant peritoneal mesothelioma.
    Am Surg. 2001 Oct;67(10):999-1003 PMID: 11603562
  38. Effect of intraperitoneal recombinant human tumour necrosis factor alpha on malignant ascites.
    Eur J Cancer. 1991;27(2):121-5 PMID: 1827272
  39. The serum-ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascites.
    Ann Intern Med. 1992 Aug 1;117(3):215-20 PMID: 1616215
  40. Ascitic fluid analysis in malignancy-related ascites.
    Hepatology. 1988 Sep-Oct;8(5):1104-9 PMID: 3417231
  41. Use of nitrogen mustard in treatment of serous effusions of neoplastic origin.
    J Am Med Assoc. 1955 Dec 31;159(18):1704-7 PMID: 13271133
  42. Malignant ascites: past, present, and future.
    J Am Coll Surg. 2004 Jun;198(6):999-1011 PMID: 15194082
  43. The matrix metalloproteinase inhibitor batimastat (BB-94) retards human breast cancer solid tumor growth but not ascites formation in nude mice.
    Clin Cancer Res. 1996 Jul;2(7):1207-14 PMID: 9816289
  44. On the treatment and prognosis of malignant ascites: is the survival time determined when the abdominal paracentesis is needed?
    J Surg Oncol. 1982 Aug;20(4):238-42 PMID: 6180252
  45. Intracavitary treatment of malignant pleural and peritoneal effusions in cancer patients.
    Anticancer Res. 1994 Mar-Apr;14(2B):739-45 PMID: 7516642
  46. Intraperitoneal therapy of malignant ascites associated with carcinoma of ovary and breast using radioiodinated monoclonal antibody 2G3.
    Gynecol Oncol. 1992 Oct;47(1):102-9 PMID: 1427388
  47. [Continuous hyperthermic peritoneal perfusion (CHPP) for prevention or treatment of peritoneal dissemination].
    Gan To Kagaku Ryoho. 1993 Aug;20(11):1622-5 PMID: 8373233
  48. A Phase II study of oxaliplatin with low-dose leucovorin and bolus and continuous infusion 5-fluorouracil (modified FOLFOX-4) for gastric cancer patients with malignant ascites.
    Jpn J Clin Oncol. 2007 Dec;37(12):930-5 PMID: 18211984
  49. Treatment and prevention of malignant ascites associated with disseminated intraperitoneal malignancies by aggressive combined-modality therapy.
    Am Surg. 1997 Feb;63(2):137-43 PMID: 9012427
  50. Intraperitoneal recombinant interferon-alpha 2b for recurrent malignant ascites due to ovarian cancer.
    Cancer. 1989 Sep 1;64(5):1029-33 PMID: 2758381
  51. Intraperitoneal chemotherapy with mitoxantrone in malignant ascites.
    Surg Oncol Clin N Am. 2003 Jul;12(3):865-72, xvi-xvii PMID: 14567037
  52. Management of cirrhosis and ascites.
    N Engl J Med. 2004 Apr 15;350(16):1646-54 PMID: 15084697
  53. Intracavitary beta-interferon for the management of pleural and/or abdominal effusions in patients with advanced cancer refractory to chemotherapy.
    In Vivo. 1991 Nov-Dec;5(6):579-81 PMID: 1810442
  54. Efficacy of cisplatin-based intraperitoneal chemotherapy as treatment of malignant peritoneal mesothelioma.
    J Cancer Res Clin Oncol. 1992;118(7):547-50 PMID: 1624547
  55. Selection of patients with malignant ascites for a peritoneovenous shunt.
    Cancer. 1982 Sep 15;50(6):1204-9 PMID: 7104966
  56. New approach to management of malignant ascites with a streptococcal preparation, OK-432. I. Improvement of host immunity and prolongation of survival.
    Surgery. 1983 Mar;93(3):357-64 PMID: 6187080
  57. Malignant ascites: a 2-year review from a teaching hospital.
    Eur J Surg Oncol. 1996 Jun;22(3):237-9 PMID: 8654603
  58. Phase I study of intraperitoneal metalloproteinase inhibitor BB94 in patients with malignant ascites.
    Clin Cancer Res. 1998 Aug;4(8):1899-902 PMID: 9717817
  59. Differential macromolecular leakage from the vasculature of tumors.
    Cancer. 1986 Feb 1;57(3):461-4 PMID: 2417677
  60. Matrix metalloproteinase inhibitors: applications in oncology.
    Invest New Drugs. 1999;17(4):387-99 PMID: 10759405
  61. Evaluation of a standardized protocol of intracavitary recombinant interferon alpha-2b in the palliative treatment of malignant peritoneal effusions. A prospective pilot study.
    Oncology. 2001;61(3):192-6 PMID: 11574774
  62. Phase I clinical and pharmacologic study of intraperitoneal cisplatin and fluorouracil in patients with advanced intraabdominal cancer.
    J Clin Oncol. 1990 Dec;8(12):2054-61 PMID: 2230897
  63. Indwelling catheters for the management of malignant ascites.
    Support Care Cancer. 2000 Nov;8(6):493-9 PMID: 11094995
  64. Differential inhibition of fluid accumulation and tumor growth in two mouse ascites tumors by an antivascular endothelial growth factor/permeability factor neutralizing antibody.
    Cancer Res. 1998 Jun 15;58(12):2594-600 PMID: 9635584
  65. The positive peritoneal effusion. A retrospective study of cytopathologic diagnoses with autopsy confirmation.
    Acta Cytol. 1993 Jul-Aug;37(4):483-8 PMID: 8328242
  66. A phase II trial of triamcinolone hexacetanide for symptomatic recurrent malignant ascites.
    J Pain Symptom Manage. 2000 Mar;19(3):193-9 PMID: 10760624
  67. Comparison of percutaneous management techniques for recurrent malignant ascites.
    J Vasc Interv Radiol. 2004 Oct;15(10):1129-31 PMID: 15466800
  68. Radioactive colloidal chromic phosphate to control pleural effusion and ascites.
    J Am Med Assoc. 1958 Feb 8;166(6):597-9 PMID: 13502033
  69. The successful treatment of chylous effusions in malignant disease with octreotide.
    Clin Oncol (R Coll Radiol). 2005 Apr;17(2):118-21 PMID: 15830574
  70. Phase I/II trial of batimastat, a matrix metalloproteinase inhibitor, in patients with malignant ascites.
    Eur J Surg Oncol. 1997 Dec;23(6):526-31 PMID: 9484924
  71. Peritoneovenous shunts for palliation of the patient with malignant ascites.
    Ann Surg Oncol. 1994 Sep;1(5):378-81 PMID: 7531600
  72. Targeting vascular endothelial growth factor blockade: ascites and pleural effusion formation.
    Oncologist. 2000;5 Suppl 1:45-50 PMID: 10804091
  73. [Intraperitoneal chemo-hyperthermia with mitomycin C in cancer of the stomach with peritoneal carcinosis].
    J Chir (Paris). 1997 Nov;134(5-6):237-42 PMID: 9772980
  74. Treatment of pleural and peritoneal effusion with intracavitary colloidal radiogold (Au 198).
    Arch Intern Med. 1959 Nov;104:802-15 PMID: 13818972
Article Info
Journal
Current treatment options in oncology
Abbr.
Curr Treat Options Oncol
ISSN
1534-6277
DOI
10.1007/s11864-008-0068-y
Published
2008-06-00
Epub
2008-00-06
Pages
215-33
Language
English
Region
United States
NLM ID
100900946
Subset
IM
External Links
PubMed source DOI: 10.1007/s11864-008-0068-y View journal details
Analysis Services
Analysis Services

Contact

No. 2 Wenbo Road, Zhangqiu District, Jinan, Shandong

Qilu Normal University · Genelibs Bioinformatics Lab

750 Shunhua Rd, Jinan

2F, Bldg F, University Science Park

Tel: 0531-88819269

WeChat Official Account

Follow our WeChat subscription account for real-time updates and the latest in medical and biological research.


Business Email

E-mail: product@genelibs.com

Copyright © 2026.Genelibs Jinan Honghui Biotechnology Co., Ltd. 鲁ICP备20007159号-2