Update on the differential diagnosis of gynecologic organ-related diseases in women presenting with ascites

Su, Ming-Hsuan; Cho, Shu-Wen; Kung, Yu-Shan; Lin, Jen-Tai; Lee, Wen-Ling; Wang, Peng-Hui

doi:10.1016/j.tjog.2019.07.002

Cited by 14 publications

(8 citation statements)

References 61 publications

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“…However, the prognosis of patients with ETOC and PPSC is still disappointing, because of vague or free symptoms of patients, often misdiagnosed as less deadly gastro-enteral tract problems, and the absence of effective screening programs, and, in addition, its heterogeneous nature and different clinical development, accounting for late diagnosis in its advanced stages [52][53][54][55]. All result in a therapeutic challenge, contributing to low cure rate and high mortality rate, [1][2][3][4][5][19][20][21][22][23][24][25].…”

Section: Current Standard Of Treatmentmentioning

confidence: 99%

Comparing Paclitaxel–Carboplatin with Paclitaxel–Cisplatin as the Front-Line Chemotherapy for Patients with FIGO IIIC Serous-Type Tubo-Ovarian Cancer

Huang

Chen

Lee

et al. 2020

IJERPH

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The use of weekly chemotherapy for the treatment of patients with advanced-stage serous-type epithelial Tubo-ovarian cancer (ETOC), and primary peritoneal serous carcinoma (PPSC) is acceptable as the front-line postoperative chemotherapy after primary cytoreductive surgery (PCS). The main component of dose-dense chemotherapy is weekly paclitaxel (80 mg/m2), but it would be interesting to know what is the difference between combination of triweekly cisplatin (20 mg/m2) or triweekly carboplatin (carboplatin area under the curve 5-7 mg/mL per min [AUC 5-7]) in the dose-dense paclitaxel regimen. Therefore, we compared the outcomes of women with Gynecology and Obstetrics (FIGO) stage IIIC ETOC and PPSC treated with PCS and a subsequent combination of dose-dense weekly paclitaxel and triweekly cisplatin (paclitaxel–cisplatin) or triweekly carboplatin using AUC 5 (paclitaxel–carboplatin). Between January 2010 and December 2016, 40 women with International Federation of Gynecology and Obstetrics (FIGO) stage IIIC EOC, FTC, or PPSC were enrolled, including 18 treated with paclitaxel–cisplatin and the remaining 22 treated with paclitaxel–carboplatin. There were no statistically significant differences in disease characteristics of patients between two groups. Outcomes in paclitaxel–cisplatin group seemed to be little better than those in paclitaxel–carboplatin (median progression-free survival [PFS] 30 versus 25 months as well as median overall survival [OS] 58.5 versus 55.0 months); however, neither reached a statistically significant difference. In terms of adverse events (AEs), patients in paclitaxel–carboplatin group had more AEs, with a higher risk of neutropenia and grade 3/4 neutropenia, and the need for a longer period to complete the front-line chemotherapy, and the latter was associated with worse outcome for patients. We found that a period between the first-time chemotherapy to the last dose (6 cycles) of chemotherapy >21 weeks was associated with a worse prognosis in patients compared to that ≤21 weeks, with hazard ratio (HR) of 81.24 for PFS and 9.57 for OS. As predicted, suboptimal debulking surgery (>1 cm) also contributed to a worse outcome than optimal debulking surgery (≤1 cm) with HR of 14.38 for PFS and 11.83 for OS. Based on the aforementioned findings, both regimens were feasible and effective, but maximal efforts should be made to achieve optimal debulking surgery and following the on-schedule administration of dose-dense weekly paclitaxel plus triweekly platinum compounds. Randomized trials validating the findings are warranted.

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Section: Current Standard Of Treatmentmentioning

confidence: 99%

Comparing Paclitaxel–Carboplatin with Paclitaxel–Cisplatin as the Front-Line Chemotherapy for Patients with FIGO IIIC Serous-Type Tubo-Ovarian Cancer

Huang

Chen

Lee

et al. 2020

IJERPH

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“…Besides hepatic and renal failure, which are considered the main causes of the formation of ascites, malignant and infectious intra-abdominal diseases are also responsible for the concentration of diffusion of peritoneal fluid rich in proteins [50]. With regard to malignant diseases, epithelial ovarian and tubal cancer, primary peritoneal serous carcinoma, and endometrial cancer can be associated with ascites formation [51]. Furthermore, benign ovarian cysts, endometriosis, ovarian hyperstimulation syndrome, peritoneal tuberculosis, and Meigs syndrome should also be considered in the differential diagnosis of female ascites [51].…”

Section: Discussionmentioning

confidence: 99%

“…With regard to malignant diseases, epithelial ovarian and tubal cancer, primary peritoneal serous carcinoma, and endometrial cancer can be associated with ascites formation [51]. Furthermore, benign ovarian cysts, endometriosis, ovarian hyperstimulation syndrome, peritoneal tuberculosis, and Meigs syndrome should also be considered in the differential diagnosis of female ascites [51].…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Characteristics and Outcomes of Patients With Endometriosis-Related Hemorrhagic Ascites: An Updated Systematic Review of the Literature

Pandraklakis¹,

Prodromidou²,

Haidopoulos³

et al. 2022

Cureus

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The presence of ascites is a common clinical presentation in gynecologic oncology patients. Hemorrhagic ascites (HA) due to endometriosis is a rare presentation that can be easily misdiagnosed as ovarian malignancies. The present study aims to update the currently available knowledge on the characteristics of patients presenting with HA due to endometriosis.A systematic search was conducted for articles published from January 2000 to July 2020 using the Medline, Scopus, and Google Scholar databases along with the references of the full-text articles retrieved. Papers describing cases of women over 18 years with or without previous history of endometriosis were assessed. Only cases with histologically proven hemorrhagic ascites of endometriosis origin were included.Twenty-nine studies (27 case reports and two case series) comprising 32 patients were evaluated. The mean patients' age was 32 years, while six of the patients had a previous history of endometriosis. The mean amount of drained ascitic fluid was 4,200 mL, whereas three patients underwent thoracentesis due to pleural effusions. The treatment options included not only medical but also surgical therapies. Fertility preservation was achieved in 27 patients, while two of them achieved pregnancy with in vitro fertilization (IVF) techniques.Endometriosis-related hemorrhagic ascites is a relatively rare expression of the disease. Endometriosisrelated hemorrhagic ascites should be considered in the differential diagnosis (DD) of women with ascites and clinical suspicion of endometriosis. The available literature is limited to case reports and case series and thus indicates further research in the field to decode the pathophysiology of the disease and decide on the optimal treatment.

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“…In a large number of patients, careful history taking, and examination can provide important clues such as signs of chronic liver disease or history of operations in the case of PICs. Ultrasound, computed tomography scan, and magnetic resonance imaging can be helpful in confirming the diagnosis [8].…”

Section: Diagnosis Of Picsmentioning

confidence: 99%

Peritoneal inclusion cysts as a diagnostic and treatment challenge

et al. 2021

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Update on the differential diagnosis of gynecologic organ-related diseases in women presenting with ascites

Cited by 14 publications

References 61 publications

Comparing Paclitaxel–Carboplatin with Paclitaxel–Cisplatin as the Front-Line Chemotherapy for Patients with FIGO IIIC Serous-Type Tubo-Ovarian Cancer

Comparing Paclitaxel–Carboplatin with Paclitaxel–Cisplatin as the Front-Line Chemotherapy for Patients with FIGO IIIC Serous-Type Tubo-Ovarian Cancer

Clinicopathological Characteristics and Outcomes of Patients With Endometriosis-Related Hemorrhagic Ascites: An Updated Systematic Review of the Literature

Peritoneal inclusion cysts as a diagnostic and treatment challenge

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