Ascites in Advanced Ovarian Cancer

The presence of ascites is one of the general ovarian cancer (OC) symptoms detected at initial diagnosis and can be present at an early stage but is most often seen in advanced disease. In newly diagnosed OC patients, ascites is treated by the standard treatment for the underlying disease. However, once the chemoresistant and recurrent features of the disease develop, management of a large volume of ascites can be a major problem. By increasing abdominal pressure, ascites can cause severe symptoms; thus, palliation of symptomatic patients is the main goal. The elimination of fluid accumulation in OC patients with these symptoms will certainly improve their quality of life and may even prolong survival. Unfortunately, no standard treatment for OC-associated ascites exists. There are several traditional therapies for ascites, with limited effectiveness and significant adverse effects. Catumaxomab is the only medicine approved for intraperitoneal treatment of malignant ascites in patients with EpCAM-positive carcinomas. Advances in our understanding of malignant ascites aetiology and more effective treatment strategies for ascites and OC will help reduce the symptoms associated with ascites.