A SURVEY OF PRACTICE IN MANAGEMENT OF MALIGNANT ASCITES

The purpose of this study was to determine physicians' attitudes towar d and preferences for palliative management of malignant ascites. A ra ndom sample of eighty physicians practicing in Canada was selected fro m the memberships of the Canadian Association of Medical Oncologists, the Canadian Association of Gastroenterology, the Canadian Society of Palliative Care Physicians, and the Society of Gynecologic Oncologists of Canada. Physicians were questioned on their use of different modal ities in management of malignant ascites, and preference based on atti tudes toward efficacy of various treatments. Eighty surveys were maile d, with a second mailing, followed by telephone contact. The response, ate was 76% (59/78), with two potential respondents deemed ineligible. Among the 44 physicians who treat malignant ascites, paracentesis is employed by 43 (98%), and felt to be effective by 39 (89%). Diuretics are used by 61% (27/44), although fewer feel diuretics are effective m anagement (20/44, 45%). Peritoneovenous shunts, dietary measures, and other modalities are used less frequently than either paracentesis or diuretics. The most commonly used means of managing malignant ascites is paracentesis, which is also felt to be the most effective by the gr oup surveyed. After paracentesis, diuretics and peritoneovenous shunti ng are used most frequently, but there is no apparent consensus to the ir effectiveness. Managing. malignant ascites remains problematic, and we propose further study of management strategies to clarify the role of various treatments. J Pain Symptom Manage 1998;16:96-101, (C) U.S. Cancer Pain Relief Committee, 1998.