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. 2023 Oct;38(4):473-480.
doi: 10.1177/08258597231170049. Epub 2023 Apr 24.

Is Low Volume Drainage of Ascites Associated With Improved Survival in Digestive System Cancer Patients With Malignant Ascites?-A Retrospective Cohort Study

Shunya Hoshino  1 , Yusuke Takagi  1 , Takeo Fukagawa  2 , Keiji Sano  2 , Nobuhiko Seki  3 , Yojiro Hashiguchi  2 , Etsuko Aruga  1
Affiliations

Is Low Volume Drainage of Ascites Associated With Improved Survival in Digestive System Cancer Patients With Malignant Ascites?-A Retrospective Cohort Study

Shunya Hoshino et al. J Palliat Care. 2023 Oct.

Abstract

Objectives: To determine whether the volume of paracentesis for malignant ascites in acute care hospital wards is associated with survival and symptom relief. Methods: Patients with malignant ascites caused by digestive system cancer who underwent paracentesis between January 2010 and April 2022 were retrospectively analyzed from medical records. Collected data included the drainage volume per paracentesis procedure, survival time from the first paracentesis procedure, symptoms, and adverse events. According to the volume per paracentesis procedure, we divided the patients into the "small-drainage" (≤1500 mL) and "standard-drainage" (>1500 mL) groups. Results: The median age of the 144 patients was 69 years, 33% were female, and 64% had gastrointestinal cancer. The median survival from the first paracentesis procedure was 36 days. Eighty-nine (61.8%) and 55 (38.2%) patients were allocated to the small-drainage and standard-drainage groups, respectively. The median number of paracentesis procedures in the small-drainage and standard-drainage groups was 12 and 7, respectively (P=.001). The median survival in the small-drainage and standard-drainage groups was 50 and 44 days, respectively (P=.76). The multivariate analysis showed that the amount of drainage per session was not significantly associated with survival. Symptoms improved similarly in the 2 groups. No serious adverse events were observed. Conclusions: Paracentesis was demonstrated to be effective and safe, irrespective of the amount of fluid drained, for patients with malignant ascites in an acute care hospital. Thus, a strategy of limiting the amount of drainage is not associated with longer survival.

Keywords: acutecare hospital; ascites drainage; digestive system cancer; gastrointestinal cancer; malignant ascites; paracentesis; survival; symptom relief.

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Conflict of interest statement

Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and publication of this article.

Figures

Figure 1.
Figure 1.
Patient selection flow chart.
Figure 2.
Figure 2.
Kaplan–Meier survival curves for the small-drainage and standard-drainage groups.
Figure 3.
Figure 3.
Kaplan–Meier survival curves for the small-drainage and standard-drainage groups for each Performance Status (PS 2-4).
See this image and copyright information in PMC

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