Lymphatic drainage of the peritoneal cavity and its significance in ovarian cancer

Feldman, George B.; Knapp, Robert C.

doi:10.1016/0002-9378(74)90021-0

Cited by 140 publications

(49 citation statements)

References 14 publications

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“…The peritoneal lymphatic absorption rate in our CAPD patients was 89.5±11.8 ml/h, which is consistent with prior observations in patients with hepatic (9, 13) and malignant (9,18) ascites who have no disease of the diaphragmatic or mediastinal lymphatics. Conversely, tumor invasion (18,19) or fibrosis (20) of the subdiaphragmatic lymphatics reduces peritoneal lymphatic drainage and may induce ascites formation.…”

Section: Discussionmentioning

confidence: 99%

Contribution of lymphatic absorption to loss of ultrafiltration and solute clearances in continuous ambulatory peritoneal dialysis.

Mactier¹,

Khanna²,

Twardowski³

et al. 1987

J. Clin. Invest.

151

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The contribution of peritoneal cavity lymphatic absorption to ultrafiltration kinetics and solute clearances in continuous ambulatory peritoneal dialysis was evaluated in patients with normal (group 1) and high (group 2) peritoneal permeability X area during 4-h exchanges using 2 liters 2.5% dextrose dialysis solution with 30 g added albumin. Cumulative lymphatic drainage in all continuous ambulatory peritoneal dialysis (CAPD) patients averaged 358±47 ml per 4-h exchange and reduced cumulative net transcapillary ultrafiltration at the end of the exchange by 58±7.2%. The peak ultrafiltration volume was observed before osmotic equilibrium between serum and dialysate was reached and occurred when the net transcapillary ultrafiltration rate had decreased to equal the lymphatic absorption rate. Thereafter the lymphatic absorption rate exceeded the net transcapillary ultrafiltration rate, and intraperitoneal volume decreased. Extrapolated to 4 X 2 liters, 2.5% dextrose, 6-h exchanges per d, lymphatic drainage reduced potential daily net ultrafiltration by 83.2±10.2%, daily urea clearance by 16.9±1.9%, and daily creatinine clearance by 16.5±1.9%. Although lymphatic absorption did not differ between the two groups, lymphatic drainage caused a proportionately greater reduction in net ultrafiltration in group 2 (P < 0.025), because these patients had more rapid dialysate glucose absorption (P < 0.05) and less cumulative transcapillary ultrafiltration (P < 0.01). These findings indicate that cumulative lymphatic drainage significantly reduces net ultrafiltration and solute clearances in CAPD and that ultrafiltration failure in CAPD occurs when daily lymphatic absorption equals or exceeds daily transcapillary ultrafiltration. Reduction of lymphatic absorption may provide a means for future improvement in the efficiency of CAPD.

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Section: Discussionmentioning

confidence: 99%

Contribution of lymphatic absorption to loss of ultrafiltration and solute clearances in continuous ambulatory peritoneal dialysis.

Mactier¹,

Khanna²,

Twardowski³

et al. 1987

J. Clin. Invest.

151

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“…þ tumor cells in malignant ascites during and after treatment Reduced lymphatic drainage from the peritoneal cavity due to vessel obstruction as a consequence of tumor cell growth represents one major cause for malignant ascites formation (1)(2)(3)(4). Therefore, we monitored tumor cell counts during and after therapy.…”

Section: Monitoring Of Epcammentioning

confidence: 99%

“…Thus, various types of abdominal tumors including those of the ovaries, endometrium, colon, stomach, pancreas, and others can be accompanied by this indication (1,2). It emerges whether the equilibrium between fluid production and its drainage from the peritoneal cavity is disturbed by parameters such as by vessel obstruction due to high tumor mass, impaired lymphatic drainage, or fluid overproduction often caused by an increased secretion of VEGF by peritoneal tumor cells (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Immunomonitoring Results of a Phase II/III Study of Malignant Ascites Patients Treated with the Trifunctional Antibody Catumaxomab (Anti-EpCAM × Anti-CD3)

et al. 2012

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Patients with malignant ascites secondary to primary carcinomas benefit from intraperitoneal therapy with the trifunctional antibody catumaxomab (anti-EpCAM × anti-CD3). Here, we report the analysis of peritoneal fluid samples from 258 patients with malignant ascites randomized to catumaxomab or control groups to investigate the molecular effects of catumaxomab treatment. In the catumaxomab group, tumor cell numbers and peritoneal levels of VEGF decreased, whereas the activation status of CD4+ and CD8+ T-cell populations increased more than two-fold after treatment. Notably, CD133+/EpCAM+ cancer stem cells vanished from the catumaxomab samples but not from the control samples. In vitro investigations indicated that catumaxomab eliminated tumor cells in a manner associated with release of proinflammatory Th1 cytokines. Together, our findings show that catumaxomab therapy activates peritoneal T cells and eliminates EpCAM+ tumor cells, establishing a molecular and cellular basis to understand in vivo efficacy within the immunosuppressed malignant ascites tissue microenvironment. Cancer Res; 72(1); 24–32. ©2011 AACR.

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“…The etiology of malignant pleural effusions and ascites had traditionally been attributed to lymphatic obstruction caused by tumor spread into draining lymph vessels [23][24][25][26]. It had also been suggested that tumor-induced angiogenesis might contribute to the development of peritoneal effusions [27,28].…”

Section: Vascular Endothelial Growth Factor As a Key Factor For The Imentioning

confidence: 99%

Intraperitoneal VEGF Inhibition Using Bevacizumab: A Potential Approach for the Symptomatic Treatment of Malignant Ascites?

et al. 2009

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Despite overall improvements in oncological care in the palliative setting, symptomatic malignant ascites remains a severe clinical problem. This form of effusion is known to be widely resistant to established modes of systemic therapy. Accordingly, frequent paracentesis often represents the only effective way for symptom relief in patients with advanced cancer. This invasive mode of therapy, however, is often very burdensome for the patient who is already severely distressed by the underlying malignancy. Recently, the trifunctional monoclonal antibody catumaxomab given i.p. has shown symptom relief in patients with ovarian cancer and malignant ascites. On another front, the release of vascular endothelial growth fac-

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Lymphatic drainage of the peritoneal cavity and its significance in ovarian cancer

Cited by 140 publications

References 14 publications

Contribution of lymphatic absorption to loss of ultrafiltration and solute clearances in continuous ambulatory peritoneal dialysis.

Contribution of lymphatic absorption to loss of ultrafiltration and solute clearances in continuous ambulatory peritoneal dialysis.

Immunomonitoring Results of a Phase II/III Study of Malignant Ascites Patients Treated with the Trifunctional Antibody Catumaxomab (Anti-EpCAM × Anti-CD3)

Intraperitoneal VEGF Inhibition Using Bevacizumab: A Potential Approach for the Symptomatic Treatment of Malignant Ascites?

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