Prognostic value of moderate or massive ascites in patients with advanced gastric cancer

Abstract Background Advanced gastric cancer is one of highly aggressive malignancies. The available literature does not provide the prognostic value of ascites based on its degree because most clinical trials exclude patients who present with massive ascites. Therefore, this study aimed to examine whether the presence or degree of ascites has a prognostic value in patients with advanced gastric cancer in clinical settings. Methods Totally, 124 patients with advanced gastric cancer were recruited. The degree of ascites was assessed using computed tomography (CT) and classified as none, small, moderate, or massive. The overall survival (OS) was compared based on the presence or degree of ascites. Furthermore, the Cox proportional hazards analysis was performed to ascertain the predictors of OS. Results The cumulative one year, and two year OS rates in patients without ascites were 43.5%, and 20.2%, respectively, whereas those in patients with ascites were 29.1%, and 13.6%, respectively ( P = 0.116). The cumulative one year, and two year OS rates in patients without moderate or massive ascites were 39.5%, and 20.9%, respectively, whereas those in patients with moderate or massive ascites were 28.0%, and 4.0%, respectively ( P = 0.027). In the multivariate analysis, diffuse-type (hazard ratio [HR], 1.532; 95% confidence interval [CI], 1.002–2.343; P = 0.049), moderate or massive ascites (HR, 2.153; 95% CI, 1.301–3.564; P = 0.003), and chemotherapy (HR, 0.189; 95% CI, 0.101–0.352; P < 0.001) were significant predictive factors of OS. Conclusion We determined that moderate or massive ascites influenced OS of patients with advanced gastric cancer.