Outcomes of Permanent Peritoneal Ports for the Management of Recurrent Malignant Ascites

Coupe, Nicholas; Cox, Kimberly; Clark, Katherine; Boyer, Michael; Stockler, Martin R.

doi:10.1089/jpm.2012.0535

Cited by 22 publications

(27 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We found a marked difference in the complication rate of 56% (n = 46) in patients with catheters compared with 17% (n = 11) in the group where no catheters were placed ( P < .001). These observations correlate with recent literature reports, 18,24,36–38 although we found a higher incidence of infections (spontaneous bacterial peritonitis; SBP) with 23% (n = 26) in patients with a catheter compared with 6% (n = 4) who had a paracenteses only. The increased rate of infections could be secondary to bacterial access during procedure, or through direct contact with the abdominal cavity.…”

Section: Discussionsupporting

confidence: 93%

See 1 more Smart Citation

Pancreas Adenocarcinoma: Ascites, Clinical Manifestations, and Management Implications

Hicks

Chou

Capanu

et al. 2016

Clinical Colorectal Cancer

View full text Add to dashboard Cite

This was a cohort analysis evaluating patients with pancreatic adenocarcinoma who presented with or developed ascites. Among the 180 patients analyzed, the use of serial paracenteses and indwelling catheters is a common practice to effect symptom palliation. The complication rate was higher in patients with indwelling catheters. Analyzing ascitic fluid and calculating the serum ascites albumin gradient can help attribute the etiology of the ascites and potentially identify which patients may benefit from diuretics or other intervention. Background Ascites develops in a subset of patients with pancreatic adenocarcinoma (PAC) at presentation or as the disease advances. Limited data exist on the prognostic importance of malignant ascites in PAC. Our hypothesis is that this information will provide an understanding of the natural history and facilitate management decisions. Methods We conducted a retrospective analysis of 180 patients treated at Memorial Sloan Kettering Cancer Center diagnosed between January 1, 2009 and December 31, 2014, with PAC and with ascites either at presentation or that developed during the disease course. Results For the 180 patients, the overall survival was 15 months. The time from diagnosis to ascites presentation was 11 months, and the survival time after ascites development was 1.8 months (range, 1.6–2.3 months; 95% confidence interval). Of 62 patients (34%) who had ascitic fluid analyzed, 36 (58%) had positive cytology. Fifty-one (82%) patients had a serum ascites albumin gradient ≥ 1, and 11 (18%) had serum ascites albumin gradient < 1. Sixty-four (36%) patients had their ascites managed solely by serial paracenteses. A total of 116 patients required a catheter; of these, 108 (93%) had a Tenckhoff catheter, 4 (3%) a Pleurx catheter, 4 (3%) a pigtail catheter, and 1 (1%) a Denver catheter. Eight (7%) patients required 2 catheters to be placed, and in 6 (5%), Tenckhoff catheters had to be removed. The main observed complications were spontaneous bacterial peritonitis in 7 (11%) managed with paracenteses versus 26 (23%) who had a catheter placed, catheter malfunction in 8 (7%), and acute renal failure in 6 (3%). After ascites development, 79 (44%) patients received active anti-cancer therapy, and 101 (56%) patients were managed with supportive care alone. Conclusions In patients with PAC who presented with or developed ascites, serial paracenteses and indwelling catheters are common methods used for providing symptomatic relief. The complication rate was higher with indwelling catheters, primarily related to infection (eg, bacterial peritonitis). Overall, ascites has a significantly negative prognostic import with a short median survival.

show abstract

Section: Discussionsupporting

confidence: 93%

“…16 The latter was originally developed in 1968 by Henry Tenckhoff as an indwelling peritoneal dialysis catheter 17 that has been shown to be effective. 18 …”

Section: Introductionmentioning

confidence: 99%

Pancreas Adenocarcinoma: Ascites, Clinical Manifestations, and Management Implications

Hicks

Chou

Capanu

et al. 2016

Clinical Colorectal Cancer

View full text Add to dashboard Cite

show abstract

“…The majority of patients with malignant ascites experience progressive abdominal swelling and troublesome symptoms such as pain, nausea, dyspnea, constipation, and edema (3). With the exception of ovarian cancer, malignant ascites typically have a poor prognosis and a median survival time of no more than 4 months (4).…”

Section: Introductionmentioning

confidence: 99%

Combined antitumor effects of P‑5m octapeptide and 5‑fluorouracil on a murine model of H22 hepatoma ascites

Han

Yan

et al. 2018

Exp Ther Med

View full text Add to dashboard Cite

The present study has demonstrated that P-5m octapeptide (P-5m) has therapeutic potential in metastatic human hepatocarcinoma, possibly through the modulation of matrix metalloproteinase-2 expression. The purpose of the present study was to evaluate the antitumor effect of P-5m combined with 5-fluorouracil (5-Fu) on the treatment of hepatoma 22 (H22) hepatocarcinoma malignant ascites in a mouse model. The inhibitory effect on the growth of mouse ascites tumors was monitored by measuring body weight gain, survival time, ascites volume, numbers of tumor cells, DNA synthesis and peritoneal capillary permeability analysis. The present data revealed a significant reduction in ascites volume and cell count in mice that were treated with P-5m plus 5-Fu. Furthermore, the median survival time in mice in the combination group was prolonged compared with the disease control group. Moreover, a significant reduction in the total H22 ascites cell count in mice from the combination group was observed when compared with the disease control group. P-5m plus 5-Fu was able to induce the cell cycle arrest and inhibit the peritoneal capillary permeability of the mice. To conclude, the present study indicated that P-5m may have therapeutic potential in ascites caused by hepatocellular carcinoma.

show abstract

“…Endoscopic stenting has been shown to have similar success rate as surgery with less morbidity. 26,27 However, the risk of recurrent biliary obstruction before death is higher in patients undergoing endoscopic stent placement.…”

Section: Biliary Obstructionmentioning

confidence: 99%

“…The success rates for permanent intraperitoneal catheters functioning until death are quite high (90%). 28,29 Major complications are obstruction and infection, and are approximately 17%, 27 although catheter sepsis has been reported to be 35%. 30 To avoid infection, nurses must follow patients closely and provide education to patients and caregivers on drainage and care of the catheter.…”

Section: Malignant Ascitesmentioning

confidence: 99%

Palliative Surgery: Incidence and Outcomes

Sun¹,

Krouse²

2014

Seminars in Oncology Nursing

View full text Add to dashboard Cite

Outcomes of Permanent Peritoneal Ports for the Management of Recurrent Malignant Ascites

Cited by 22 publications

References 8 publications

Pancreas Adenocarcinoma: Ascites, Clinical Manifestations, and Management Implications

Pancreas Adenocarcinoma: Ascites, Clinical Manifestations, and Management Implications

Combined antitumor effects of P‑5m octapeptide and 5‑fluorouracil on a murine model of H22 hepatoma ascites

Palliative Surgery: Incidence and Outcomes

Contact Info

Product

Resources

About