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Published in: World Journal of Surgical Oncology 1/2006

Open Access 01-12-2006 | Research

Prognostic significance of new onset ascites in patients with pancreatic cancer

Authors: Emmanuel E Zervos, Dana Osborne, Brian A Boe, German Luzardo, Steven B Goldin, Alexander S Rosemurgy

Published in: World Journal of Surgical Oncology | Issue 1/2006

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Abstract

Background

The purpose of this study was to determine risk factors for development of malignant ascites and its prognostic significance in patients with pancreatic cancer.

Methods

A prospective database was queried to identify patients with pancreatic cancer who develop ascites. Stage at presentation, size, and location of primary tumor, treatment received and length of survival after onset of ascites were determined.

Results

A total of 15 patients were identified. Of which 4 patients (1 stage II, 3 stage III) underwent pancreaticoduodenectomy and manifested with ascites 2, 3, 24 and 47 months after surgery (tumor size 2.9 ± 1.32 cm). All but one of the remaining 11 patients (tumor size 4.4 ± 3.38 cm) presented with metastatic disease, and all developed malignant ascites 9 months after diagnosis, dying 2 months later. Resected patients lived longer before the onset of ascites, but not after.

Conclusion

Once diagnosed, ascites in pancreatic cancer patients heralds imminent death. Limited survival should be considered when determining the aggressiveness of further intervention.
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Literature
1.
go back to reference Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun MJ: Cancer statistics, 2003. CA Cancer J Clin. 2003, 53: 5-26.CrossRefPubMed Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun MJ: Cancer statistics, 2003. CA Cancer J Clin. 2003, 53: 5-26.CrossRefPubMed
2.
go back to reference Zervos EE, Rosemurgy AS, Al-Saif O, Durkin AJ: Surgical management of early-stage pancreatic cancer. Cancer Control. 2004, 11: 23-31.PubMed Zervos EE, Rosemurgy AS, Al-Saif O, Durkin AJ: Surgical management of early-stage pancreatic cancer. Cancer Control. 2004, 11: 23-31.PubMed
3.
go back to reference Neoptolemos JP, Dunn JA, Stocken DD, Almond J, Link K, Beger H, Bassi C, Falconi M, Pederzoli P, Dervenis C, Fernandez-Cruz L, Lacaine F, Pap A, Spooner D, Kerr DJ, Friess H, Buchler MW: Adjuvant chemoradiotherapy and chemotherapy in resectable pancreatic cancer: a randomised controlled trial. Lancet. 2001, 358: 1576-1585. 10.1016/S0140-6736(01)06651-X.CrossRefPubMed Neoptolemos JP, Dunn JA, Stocken DD, Almond J, Link K, Beger H, Bassi C, Falconi M, Pederzoli P, Dervenis C, Fernandez-Cruz L, Lacaine F, Pap A, Spooner D, Kerr DJ, Friess H, Buchler MW: Adjuvant chemoradiotherapy and chemotherapy in resectable pancreatic cancer: a randomised controlled trial. Lancet. 2001, 358: 1576-1585. 10.1016/S0140-6736(01)06651-X.CrossRefPubMed
4.
go back to reference Adam RA, Adam YG: Malignant ascites: past, present, and future. J Am Coll Surg. 2004, 198: 999-1011. 10.1016/j.jamcollsurg.2004.01.035.CrossRefPubMed Adam RA, Adam YG: Malignant ascites: past, present, and future. J Am Coll Surg. 2004, 198: 999-1011. 10.1016/j.jamcollsurg.2004.01.035.CrossRefPubMed
5.
go back to reference Coates G, Bush RS, Aspin N: A study of ascites using lymphoscintigraphy with 99m Tc-sulfur colloid. Radiology. 1973, 107: 577-583.CrossRefPubMed Coates G, Bush RS, Aspin N: A study of ascites using lymphoscintigraphy with 99m Tc-sulfur colloid. Radiology. 1973, 107: 577-583.CrossRefPubMed
6.
go back to reference Martin JKJ, Goellner JR: Abdominal fluid cytology in patients with gastrointestinal malignant lesions. Mayo Clin Proc. 1986, 61: 467-471.CrossRefPubMed Martin JKJ, Goellner JR: Abdominal fluid cytology in patients with gastrointestinal malignant lesions. Mayo Clin Proc. 1986, 61: 467-471.CrossRefPubMed
7.
go back to reference Runyon BA, Montano AA, Akriviadis EA, Antillon MR, Irving MA, McHutchison JG: The serum-ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascites. Ann Intern Med. 1992, 117: 215-220.CrossRefPubMed Runyon BA, Montano AA, Akriviadis EA, Antillon MR, Irving MA, McHutchison JG: The serum-ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascites. Ann Intern Med. 1992, 117: 215-220.CrossRefPubMed
8.
go back to reference Runyon BA, Hoefs JC, Morgan TR: Ascitic fluid analysis in malignancy-related ascites. Hepatology. 1988, 8: 1104-1109.CrossRefPubMed Runyon BA, Hoefs JC, Morgan TR: Ascitic fluid analysis in malignancy-related ascites. Hepatology. 1988, 8: 1104-1109.CrossRefPubMed
10.
go back to reference Sayag-Beaujard AC, Francois Y, Glehen O, Sadeghi-Looyeh B, Bienvenu J, Panteix G, Garbit F, Grandclement E, Banssillon V, Vignal J, Gilly FN: Treatment of peritoneal carcinomatosis in patients with digestive cancers with combination of intraperitoneal hyperthermia and mitomycin C. Bull Cancer. 2004, 91: E113-32.PubMed Sayag-Beaujard AC, Francois Y, Glehen O, Sadeghi-Looyeh B, Bienvenu J, Panteix G, Garbit F, Grandclement E, Banssillon V, Vignal J, Gilly FN: Treatment of peritoneal carcinomatosis in patients with digestive cancers with combination of intraperitoneal hyperthermia and mitomycin C. Bull Cancer. 2004, 91: E113-32.PubMed
11.
go back to reference Trigui B, Barrier A, Flahault A, Huguier M: [Prognostic factors in advanced pancreatic cancer. Multivariate analysis of predictive survival score. University Surgery Association]. Ann Chir. 2000, 125: 625-630. 10.1016/S0003-3944(00)00252-2.CrossRefPubMed Trigui B, Barrier A, Flahault A, Huguier M: [Prognostic factors in advanced pancreatic cancer. Multivariate analysis of predictive survival score. University Surgery Association]. Ann Chir. 2000, 125: 625-630. 10.1016/S0003-3944(00)00252-2.CrossRefPubMed
12.
go back to reference Schmidt J, Fraunhofer S, Fleisch M, Zirngibl H: Is peritoneal cytology a predictor of unresectability in pancreatic carcinoma?. Hepatogastroenterology. 2004, 51: 1827-1831.PubMed Schmidt J, Fraunhofer S, Fleisch M, Zirngibl H: Is peritoneal cytology a predictor of unresectability in pancreatic carcinoma?. Hepatogastroenterology. 2004, 51: 1827-1831.PubMed
13.
go back to reference Makary MA, Warshaw AL, Centeno BA, Willet CG, Rattner DW, Fernandez-del Castillo C: Implications of peritoneal cytology for pancreatic cancer management. Arch Surg. 1998, 133: 361-365. 10.1001/archsurg.133.4.361.CrossRefPubMed Makary MA, Warshaw AL, Centeno BA, Willet CG, Rattner DW, Fernandez-del Castillo C: Implications of peritoneal cytology for pancreatic cancer management. Arch Surg. 1998, 133: 361-365. 10.1001/archsurg.133.4.361.CrossRefPubMed
14.
go back to reference Fernandez-del Castillo CL, Warshaw AL: Pancreatic cancer. Laparoscopic staging and peritoneal cytology. Surg Oncol Clin N Am. 1998, 7: 135-142.PubMed Fernandez-del Castillo CL, Warshaw AL: Pancreatic cancer. Laparoscopic staging and peritoneal cytology. Surg Oncol Clin N Am. 1998, 7: 135-142.PubMed
15.
go back to reference Fernandez-del Castillo C, Rattner DW, Warshaw AL: Further experience with laparoscopy and peritoneal cytology in the staging of pancreatic cancer. Br J Surg. 1995, 82: 1127-1129.CrossRefPubMed Fernandez-del Castillo C, Rattner DW, Warshaw AL: Further experience with laparoscopy and peritoneal cytology in the staging of pancreatic cancer. Br J Surg. 1995, 82: 1127-1129.CrossRefPubMed
Metadata
Title
Prognostic significance of new onset ascites in patients with pancreatic cancer
Authors
Emmanuel E Zervos
Dana Osborne
Brian A Boe
German Luzardo
Steven B Goldin
Alexander S Rosemurgy
Publication date
01-12-2006
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2006
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-4-16

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