Palliative Care Outcomes in the Management of Malignant Ascites by Interventional Radiology
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Malignant ascites leads to significant morbidity in patients with terminal cancer. Paracentesis can provide relief, but repeat hospital visits, pain, and short duration of relief after paracentesis are detrimental to quality of life(QOL). Two devices are available as alternatives to paracentesis. The impact of either device on QOL has not fully been explored. A pilot nonrandomized trial measuring palliative care QOL and ascites symptom relief using validated survey instruments is proposed.
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Layout table for eligibility information
Ages Eligible for Study:
18 Years and older (Adult, Older Adult)
Sexes Eligible for Study:
Accepts Healthy Volunteers:
Adult patients with refractory malignant ascites secondary to GU or GI malignancy.
Refractory malignant ascites defined as ascites requiring more than one paracentesis to control patient symptoms despite medical therapy with diuretics and a. peritoneal fluid with cytology positive for malignant cells OR
Known malignancy with imaging findings of peritoneal carcinomatosis .
Eastern Cooperative Oncology Group (ECOG) performance score 3
Age greater than or equal to 18
Capable of giving informed consent
Life expectancy less than one month
Coagulopathy defined as international normalized ration (INR) >2 which cannot be corrected with fresh frozen plasma
Platelet count <50,000/microliter, which cannot be corrected with platelet transfusion
Active skin infections at sites where PVS would be inserted
Presence of infectious peritonitis or bacteremia
American Heart Association Class D congestive heart failure (ie New York Heart Association Class IV)
Stage 5 CKD (ie GFR < 15 mL/min)
Severe hypoalbuminemia defined as < 2.2 g/dL
Loculated or hemorrhagic ascites
History of bleeding gastroesophageal varices
Inability to provide informed consent
Unable to participate in neuropsychological tests / questionnaires