Pattern and prognostic factors in patients with malignant ascites: a retrospective study

Background: Malignant ascites is a manifestation of end stage events in a variety of cancers and associated with a poor prognosis. We evaluated the pattern of cancers causing malignant ascites and factors affecting survival. Patients and methods: Patients coded with the International Classification of Diseases-9 coding system for malignant ascites over a 2-year period were reviewed. The clinicopathological data and patients' survival were compared among cancer groups. Results: There were 209 patients (140 females and 69 males), median age being 67 (30-98) years. The commonest cancer was ovarian followed by gastrointestinal (GI) cancers. Fifty-eight per cent of the patients had symptoms related to the ascites. Liver metastases were significantly commoner in the GI cancers (P = 0.0001). Fifty-four per cent of our patients presented with ascites at the initial diagnosis of their cancer. Paracentesis was given to 112, diuretics to 70 and chemotherapy to 103 patients. The median survival following diagnosis of ascites was 5.7 months. Ovarian cancer favoured 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. Conclusion: The identified independent prognostic factors should be used to select patients for multimodality therapy for adequate palliation.