Sangisetty and Miner identified prognostic factors for a patient with malignant ascites. These can help to triage patients for management. The authors are from Brown University in Providence, Rhode Island.
Patient selection: malignant ascites
Goals are early diagnosis and management of symptoms with cure currently improbable.
Prognostic factors associated with poor prognosis:
(1) edema
(2) low serum albumin concentration
(3) liver metastases
(4) low protein concentration in the ascites fluid (transudate-like)
(5) adenocarcinoma arising from the foregut (proximal GI tract)
(6) poor response to therapy
where:
• The low serum albumin may reflect protein malnutrition. Protein malnutrition may be associated with depressed immune function.
• Recurrent paracentesis of large fluid volumes may aggravate protein malnutrition.
The prognosis tends to be worse as the number of poor prognostic factors increase.
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