Patterns and prognostic factors of malignant ascites in hospitalized patients with advanced stage cancer.

Abstract

e24141 Background: Ascites is a shared pathological manifestation of numerous diseases, the primary (81%) disease being hepatic cirrhosis. Ascites is termed “malignant” when it is associated with cancers. It can manifest as abdominal swelling, abdominal pain, nausea and vomiting, anorexia and fatigue. Our study aimed at identifying baseline characteristic in patients who present to our hospital with malignant ascites as the first sign of advanced stage cancers and the factors that can affect outcomes in such patients. Methods: This is a retrospective study which includes all the patients who had been diagnosed with malignant ascites at our institute between the years 2012 and 2016.The diagnosis was made either on the basis of cytological examination or medical imaging or both. Patients who were younger than 18 years and who developed ascites due to diseases other than malignancy were excluded from the study. A total of 150 patients were shortlisted using these criteria. Results: The mean age of the sample was 56.52 years with 101 (67%) of the patients being female, 54 (36%) diabetic, 55 (37%) hypertensive, 26 (52%) and 12 (8%) had ischemic heart disease. The most prevalent tumor reported was ovarian cancer 47 (31%) with the highest frequency of metastasis reported in the peritoneal region 34 (23%). Among symptoms, the most prevalent were abdominal distension 127 (85%), abdominal pain 99 (66%), 41 (27%) nausea, 44 (29%) vomiting and 32 (21%) reported weight change. Paracentesis was done in 139 (92%) for palliation of symptoms .Surgery was performed on 11 (7%) of the patients, whereas 70 (47%) of the patients were switched to chemotherapy with Carboplatin-Taxol constituting the major chemotherapeutic regimen. Majority 93 (62%) of the patients were discharged in a stable condition. The median survival following diagnosis of ascites was three months. Ovarian cancer favored longer survival while low serum albumin, low serum protein and liver metastases adversely affected survival. The independent prognostic factors for survival were cancer type, liver metastases and serum albumin. Conclusions: The identified independent prognostic factors should be used to select patients for multimodality therapy for adequate palliation.