Peritoneovenous shunt (PVS) for malignant ascites. An analysis of outcome

Fifty cases of malignant ascites were studied to determine what factors influenced outcome after peritoneovenous shunt. There were 36 women and 14 men. The five most common tumor types were colon, breast, gastric, pancreatic, and unspecified adenocarcinoma. Multivariate analysis between those patien...

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Bibliographic Details
Published inThe American surgeon Vol. 55; no. 7; p. 445
Main Authors Smith, D A, Weaver, D W, Bouwman, D L
Format Journal Article
LanguageEnglish
Published United States 01.07.1989
Subjects
Adenocarcinoma - complications
Adenocarcinoma - mortality
Adult
Aged
Ascites - etiology
Ascites - mortality
Ascites - therapy
Breast Neoplasms - complications
Breast Neoplasms - mortality
Colonic Neoplasms - complications
Colonic Neoplasms - mortality
Female
Humans
Male
Middle Aged
Neoplasms - complications
Neoplasms - mortality
Pancreatic Neoplasms - complications
Pancreatic Neoplasms - mortality
Peritoneovenous Shunt - adverse effects
Sex Factors
Stomach Neoplasms - complications
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Summary:Fifty cases of malignant ascites were studied to determine what factors influenced outcome after peritoneovenous shunt. There were 36 women and 14 men. The five most common tumor types were colon, breast, gastric, pancreatic, and unspecified adenocarcinoma. Multivariate analysis between those patients surviving longer than 7 weeks (n = 20) and those who died in less than 7 weeks (n = 30) showed that women did uniformly better than men, even excluding the "female malignancies" (P less than 0.01). An elevated white blood cell count (WBC) and low platelets also were strong predictors of poor outcome (P less than 0.5 for difference in means between the two groups). Patients with pancreatic cancer and ascites fared poorly (80% mortality by 7 weeks) as did those with colon cancer (73% mortality by 7 weeks). By contrast, 50 per cent of the patients with breast and gastric cancer lived more than 7 weeks. Twelve patients had a LaVeen shunt placed, compared with 38 who had a Denver shunt. Fifty per cent of the La Veen shunts failed, with a mean time to failure of 69 days (P less than 0.01). Shunt failure, however, had no influence on overall survival.
ISSN:0003-1348