Predictors of Poor Prognosis in Patients with Malignant Ascites: A Prospective Study

Malignant ascites is a manifestation of end stage events in a variety of cancers with significant morbidity and a poor prognosis.This study prospectively evaluated factors predicting poor prognosis in patients with malignant ascites. Clinico-pathologic data of patients with malignant ascites at our institution over a period of 18 months were prospectively analysed. Predictors of poor survival were evaluated and survival compared among different cancer groups. A total of 150 patients (96 females, 54 males) with median age of 63 (19-95) years were studied. The commonest cancer was ovarian. Liver metastases were significantly commoner in the gastrointestinal cancers (P=0.0001). Serial paracentesis was offered to 131, chemotherapy in 89, diuretics in 35, intraperitoneal monoclonal antibody in 6 and 7 patients had drainage at surgery. The median survival after the diagnosis of malignant ascites was 9.2 months. Ovarian cancer and female gender favour longer survival while poor performance status, low serum albumin/serum protein, liver metastases, high serum urea, creatinine and total bilirubin levels adversely affected survival. The independent prognostic factors for survival were poor performance status, cancer type, liver metastases, low serum albumin and high urea levels. The cancer type and performance status significantly influence the choice of treatment option.