Clinical Gastroenterology Vol.34 No.8(3-4)

Theme Advancement of Medical Practice for Peritonitis and Ascites
Title Management of Peritoneal Cancer Secondary to Gynecological Malignancy
Publish Date 2019/07
Author Shin Nishio Department of Obstetrics and Gynecology, Kurume University School of Medicine
[ Summary ] Ovarian cancer (OC) is the eighth most lethal gynecological malignancy and serves as the primary cause of gynecological cancer deaths in industrialized countries. Malignant ascites often occurs in women with OC, and approximately 10 % of women develop recurrent OC. Tumor cells in malignant ascites secondary to OC promote disease recurrence, and mortality is mainly associated with widespread metastasis to serosal surfaces and accompanying peritoneal effusions. Targeted therapies have recently been developed as novel therapeutic options for malignant ascites. The tri‒functional anti‒epithelial cell adhesion molecule and the anti‒cluster of differentiation 3 monoclonal antibody catumaxomab have been assessed to treat malignant ascites and have shown proven efficacy in significantly reducing the ascitic flow rate when administered intraperitoneally. The anti‒angiogenic agent bevacizumab has shown good efficacy in the symptomatic treatment of malignant ascites, significantly prolonging the time interval between paracentesis. These agents are effective in symptomatic control of ascites, leading to a rapid reduction in effusion and also prolong the time interval between paracentesis. However, further large‒scale studies are required to conclusively determine whether the reduction in ascites using targeted therapy with these agents can prolong tumor‒related survival in such patients.
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