Parameters Predicting Poor Prognosis in Patients with Malignant Ascites in Yangon General Hospital

Abstract

Prognosis for patients with malignant ascites is poor and median survival is only a few months. Treatment of malignant ascites ranges from simple drainage procedures to chemotherapy and debulking surgery. Careful selection of treatment modality by using clinicpathological parameters could improve not only the survival but also the quality of life of the patients. So this hospital-based prospective study aimed to find out the parameters predicting poor prognosis among patients with confirmed malignant ascites admitted to Oncology Department, Yangon General Hospital. This study included 102 patients with malignant ascites. Among them, 19(18.6%) were male patients and 83(81.4%) were female with age ranging from 15 to 73 years (mean age 46.35±12.9 years). Common cancers associated with malignant ascites were ovarian cancer (32.35%), stomach cancer (19.61%) and breast cancer (9.80%). Sixty-four percent of patients presented with stage IV. Common metastatic sites were liver (37.27%), peritoneum (16.67%) and lungs (11.76%) and 28 patients (27.45%) had more than one site of metastasis. Eight patients (7.8%) were in Eastern Cooperative Oncology Group (ECOG) per-formance status score 1 and 23 patients (22.5%) were in ECOG score 4. The time interval between first diagnosis and development of malignant ascites ranged from 0 to 120 months. Only 33 patients (32.4%) were still alive after 6-month follow- up. High serum urea level was associated with better prognosis (OR =0.19, 95% CI 0.04-0.99), however, primary advanced stage (OR=3.30, 95% CI 1.26-258.62), and high serum creatinine level (OR=9.15, 95% CI 1.71-71.21) significantly worsened the prognosis in patients with malignant ascites.