An Early Safety and Efficacy Study of Ascites Management: Standard Paracentesis or Early Intervention With Pleurx Catheters in Patients With Malignant Ascites

Inclusion Criteria

• •(Patients can receive chemotherapy at the discretion of treating oncologist)
• •1. Patients with recurrent malignant ascites
• •2. Patients with refractory malignant ascites
• •3. Proven malignancy
• •4. Age \>= 18 years old
• •5. Eastern Cooperative Oncology Group (ECOG) performance scale =\< 2
• •6. Ability to understand and willingness to sign a written informed consent
• •Definitions:
• •Malignant ascites: One of the following criteria
• •1. Positive ascitic fluid cytology
• •2. Histology proven malignancy with imaging studies with evidence of liver metastasis and ascites
• •3. Malignant Budd Chiari Syndrome with associated ascites
• •4. Hepatocellular carcinoma and ascites
• •5. Chylous ascites due to lymphoma
• •6. Peritoneal carcinomatosis and concurrent ascites
• •7. Proven abdominal malignancy with concurrent ascites
• •Refractory / Recurrent ascites: One of the following criteria
• •1. Symptomatic ascites that recurred after one paracentesis in a patient with known malignant ascites.
• •2. Symptomatic ascites that did not respond clinically to at least two weeks of diuretics. Use of diuretics at the discretion of the treating physician.
• •3. Intolerance or relative contraindications to diuretics: (serum sodium (Na) concentration of \<125 mmol per liter or serum creatinine \>1.5 mg/dl, hyperkalemia (potassium \>5.2 mEq/L or azotemia Bun/Creatinine ratio \> 20).
• •4. Removal of at least 5 L in the preceding two months for symptoms relief