Determinants and prognostic implications of malignant ascites in metastatic papillary renal cancer.

•Malignant ascites is a clinically challenging problem and leads to considerable morbidity.•There has not been a systematic evaluation of its incidence in papillary renal cell cancer (pRCC).•We found that this manifestation is fairly common in metastatic pRCC.•Moreover, malignant ascites significantly worsens the survival of these patients.•Elevated platelet-lymphocyte ratio predicts the development of malignant ascites.•PLR can be a readily available measure of the risk of developing ascites in patients with metastatic pRCC.