The Current and Future Management of Malignant Ascites

摘要: Malignant ascites occurs in association with a variety of neoplasms. It is frequent cause morbidity and presents significant problems for which there are no clear management guidelines. In this article we discuss various modalities available including diuretic therapy, paracentesis, peritoneovenous shunts intraperitoneal chemotherapy. There randomized trials drugs to assess their efficacy malignant ascites. Phase II data suggest that they effective approximately one-third patients malignancy, may be determined by plasma renin/aldosterone concentrations. Paracentesis provides relief up 90% patients; because varying reports hypovolaemia, some advocate simultaneous intravenous fluid infusion. Permanent percutaneous drains prevent the need repeated although potential infection. A shunt also prevents paracenteses, whilst maintaining normal serum albumin Blockage 25% shunts, contraindicated presence heavily bloodstained risk occlusion. The preclinical clinical experience anti-angiogenic agents such as matrix metalloproteinase inhibitors VEGF antagonists suggests these have role treatment