Management Strategies for Malignant Ascites
Summary
Malignant ascites represent one of the most challenging complications of advanced intra-abdominal and gynaecological malignancies worldwide, imposing a profound impact on patient comfort, mobility and nutritional status. The management landscape encompasses established procedures to evacuate fluid and innovative methods to preserve protein balance, alongside evolving systemic and intraperitoneal therapies targeting underlying disease. Symptom relief through large-volume paracentesis remains the cornerstone of care, supplemented by diuretic regimens in selected cases. Peritoneal access devices, shunting techniques and reinfusion therapies seek to reduce treatment frequency and support quality of life, while emerging pharmacological and device-based interventions promise to refine personalised care pathways. Multidisciplinary collaboration is crucial to balance efficacy, safety and patient preferences in this palliative setting.
Research from Nature Portfolio
Foundational controlled cohort research has demonstrated that the reinfusion of cell-free, concentrated ascitic fluid markedly elevates serum albumin levels compared with simple paracentesis, leading to improved dietary intake, increased urine output and extended intervals before re-drainage. Although associated with mild febrile reactions, this approach offers a compelling strategy to preserve oncotic pressure and reduce the need for repeated fluid removal.
Management Strategies for Malignant Ascites publication trend
The graph below shows the total number of articles in management strategies for malignant ascites across all publications each year (not limited to Nature Index journals).
Technical terms
Malignant ascites: The accumulation of fluid in the peritoneal cavity secondary to cancerous involvement of the peritoneum or impaired lymphatic drainage.
Paracentesis: A procedure in which fluid is withdrawn from the abdominal cavity using a needle or catheter to relieve pressure and discomfort.
Cell-free and concentrated ascites reinfusion therapy (CART): A technique involving filtration and concentration of withdrawn ascitic fluid followed by reinfusion of the protein-rich fraction to restore oncotic pressure.
Tunnelled peritoneal catheter: An indwelling catheter placed beneath the skin and into the peritoneal cavity to allow repeated drainage of ascitic fluid with minimal patient discomfort.
References
- Verification of serum albumin elevating effect of cell-free and concentrated ascites reinfusion therapy for ascites patients: a retrospective controlled cohort study. Scientific Reports (2019).
- Effectiveness of Cell-Free and Concentrated Ascites Reinfusion Therapy in the Treatment of Malignancy-Related Ascites: A Systematic Review and Meta-Analysis. Cancers (2021).
- Continuous low flow ascites drainage through the urinary bladder via the Alfapump system in palliative patients with malignant ascites. BMC Palliative Care (2019).
- Tunnelled Peritoneal Catheter for Malignant Ascites—An Open-Label, Prospective, Observational Trial. Cancers (2021).
About these summaries
This Nature Research Intelligence Topic summary is created with the cited references and a large language model. We take care to ground generated text with facts, and have systems in place to gain human feedback on the overall quality of the process in line with our AI principles. We strive to create accurate and useful summaries for people unfamiliar with the research topic and that supports this goal. These pages are a beta release and will be updated as we learn how best to help people gain value from a research topic summary.
Turn complex research questions into confident strategic decisions
When you're under pressure to set direction, justify investment, or understand your competitive position, you need more than raw data — you need trusted insights you can act on.
Benchmark your performance against global peers using robust, methodologically sound analysis.
Combine quantitative metrics with qualitative expert insight to uncover strengths, gaps and emerging opportunities.
Gain tailored, decision-ready recommendations aligned to your strategic priorities.
Talk to us to learn more about our data dashboards and bespoke strategy reports.
Grow research skills, confidence and careers with training built for every stage of the research lifecycle.
Developed with Nature Portfolio journal Editors and internationally renowned experts. Discover three ways to learn:
Self-paced, online courses in convenient bite-sized units, covering key skills across scientific writing, publishing, grant writing, data analysis, and more.
Expert trainer-led workshops with hands-on exercises and real-time feedback across core research skills, delivered via interactive group sessions.
Editor-led workshops combining core principles in writing and publishing, personalised 1:1 feedback from Nature Portfolio Editors and hands-on exercises.
Explore course catalogues and workshop agendas, enquire about the options or request institutional pricing.