恶性腹水在转移性胰腺癌（mPC）中很常见，其管理仍然是临床挑战。早期识别存在腹水风险的患者可支持和指导治疗决策。通过回顾性图表审查收集2010年至2019年间在维也纳医科大学治疗mPC的患者数据。腹水被定义为腹部超声或CT扫描诊断的临床相关腹腔积液。我们调查了一般危险因素，转移部位，肝功能，全身炎症以及门静脉梗阻（PVO）和腹水发展之间的关系。在本研究中包括581位mPC患者中，122人（21.0％）在诊断转移性疾病后中位数8.7个月后出现腹水。腹水的发生导致死亡风险增加8.9倍[置信区间（CI）为7.2-11，P < 0.001]，之后中位总生存期为1个月。腹水的临床危险因素是男性[Hazard Ratio（HR）1.71，CI 1.00-2.90，P = 0.048]，腹膜癌转移（HR 6.79，CI 4.09-11.3，P < 0.001），肝转移（HR 2.16，CI 1.19-3.91，P = 0.011），白蛋白-胆红素（ALBI）评分3级（HR 6.79，CI 2.11-21.8，P = 0.001），PVO（HR 2.28，CI 1.15-4.52，P = 0.019）和高C-反应蛋白（CRP）（HR 4.19，CI 1.58-11.1，P = 0.004）。mPC患者在腹水诊断后的生存期非常有限。男性、肝和腹膜转移、肝功能受损、PVO以及全身炎症被识别为这个独特大实际患者群体中腹水发展的独立危险因素。版权所有©2023作者。由Elsevier Ltd.出版。保留所有权利。

Malignant ascites is common in metastatic pancreatic cancer (mPC) and its management still remains a clinical challenge. Early identification of patients at risk for ascites development may support and guide treatment decisions.Data of patients treated for mPC at the Medical University of Vienna between 2010 and 2019 were collected by retrospective chart review. Ascites was defined as clinically relevant accumulation of intraperitoneal fluid diagnosed by ultrasound or computer tomography scan of the abdomen. We investigated the association between general risk factors, metastatic sites, liver function, systemic inflammation as well as portal vein obstruction (PVO) and ascites development.Among 581 patients with mPC included in this study, 122 (21.0%) developed ascites after a median of 8.7 months after diagnosis of metastatic disease. The occurrence of ascites led to an 8.9-fold increased risk of death [confidence interval (CI) 7.2-11, P < 0.001] with a median overall survival of 1 month thereafter. Clinical risk factors for ascites were male sex [hazard ratio (HR) 1.71, CI 1.00-2.90, P = 0.048], peritoneal carcinomatosis (HR 6.79, CI 4.09-11.3, P < 0.001), liver metastases (HR 2.16, CI 1.19-3.91, P = 0.011), an albumin-bilirubin (ALBI) score grade 3 (HR 6.79, CI 2.11-21.8, P = 0.001), PVO (HR 2.28, CI 1.15-4.52, P = 0.019), and an elevated C-reactive protein (CRP) (HR 4.19, CI 1.58-11.1, P = 0.004).Survival after diagnosis of ascites is very limited in mPC patients. Male sex, liver and peritoneal metastases, impaired liver function, PVO, as well as systemic inflammation were identified as independent risk factors for ascites development in this uniquely large real-life patient cohort.Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.