In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 39, No. 15_suppl ( 2021-05-20), p. e24063-e24063
Abstract:
e24063 Background: Malignant ascites (MA) is associated with progressive deterioration in quality of life and poor prognosis of patients with cancer. Paracentesis is among the most widely utilised treatments for MA. However, reports on the usefulness of paracentesis in patients with MA are limited. Thus, this study aimed to investigate whether paracentesis affects the duration of survival in such patients. Methods: We performed a post - hoc analysis of a prospective multicentre observational study that investigated the dying process and end-of-life care in patients with terminal cancer, who were admitted to 23 palliative care units in Japan. Survival duration was compared between patients who did (paracentesis group) and did not undergo paracentesis (non-paracentesis group). We used the inverse probability of treatment weighting (IPTW) method to control for baseline covariates between the two groups. Furthermore, subgroup analyses were performed to investigate the IPTW-adjusted hazard ratio (HR) of the paracentesis and non-paracentesis groups according to some of the baseline covariates, including age, sex, Karnofsky Performance Status, primary tumor site, liver dysfunction, and renal dysfunction. Results: Among the 1,896 patients, who were initially enrolled, 568 with ascites were included in the study cohort. Eighty-five (15.0%) patients underwent paracentesis. The most common primary tumour site was the gastrointestinal tract (51.9%, n = 295), followed by the pancreas (22.7%, n = 129). The non-adjusted median durations of survival were 22 days (95% confidence interval [CI]: 16–25) and 12 days (95% CI: 11–13) in the paracentesis and non-paracentesis groups, respectively (HR: 0.69, [95% CI: 0.54–0.88] ; p = 0.003). The IPTW-adjusted median durations of survival were 22 days (95% CI: 16–25) and 16 days (95% CI: 12–22) in the paracentesis and non-paracentesis groups, respectively (HR: 0.89, 95% CI: 0.64–1.24; p = 0.492). There were no serious adverse events in the paracentesis group. According to the baseline covariates, a weighted subgroup analysis was performed to compare the survival of patients in the non-paracentesis and paracentesis groups. There was no significant heterogeneity across all subgroups. Paracentesis was not associated with a significant survival risk in any of the subgroups. Conclusions: Paracentesis does not negatively affect the survival of patients with cancer and MA; hence, it can be used as a standard treatment in palliative care settings.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/JCO.2021.39.15_suppl.e24063
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2021
detail.hit.zdb_id:
2005181-5
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