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Tenckhoff tunneled peritoneal catheter placement in the palliative treatment of malignant ascites: technical results and overall clinical outcome

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Inge Indesteege

Inge Indesteege

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Annouschka Laenen

Annouschka Laenen

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y

| 07 feb 2016

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Radiology and Oncology

Volumen 50 (2016): Edición 2 (June 2016)

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Article Category: Research Article

Publicado en línea: 07 feb 2016

Páginas: 197 - 203

Recibido: 13 oct 2015

Aceptado: 20 dic 2015

DOI: https://doi.org/10.1515/raon-2016-0002

© 2016 Radiol Oncol

This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

(A) Ultrasound-guided puncture of the ascitic fluid. The tip of the puncture needle (white arrow) is located within the fluid, far from intestinal or other abdominal structures. (B) Using a 4F Cobra catheter (black arrow), the hydrophilic guide wire (arrowheads) is navigated to the lower portion of the pelvis. (C) The hydrophilic guide wire is exchanged for a stiff Amplatz wire (arrowheads) on the Cobra catheter (arrow). (D) The 15F peel-away sheath (white arrows) is introduced into the peritoneal cavity over the stiff Amplatz wire (arrowheads). (E) The Tenckhoff catheter (white arrows) is introduced through the 15F peel-away sheath into the peritoneal cavity.

Schematic drawing of the Tenckhoff catheter: the intraperitoneal portion contains small fenestrations over a length of 15 cm. Two cuffs with a length of 1 cm are positioned in the subcutaneous tissues.

Overall survival after Tenckhoff catheter insertion with 95% confidence limits.

Overall estimated survival for different cancer types after Tenckhoff catheter insertion.

Overall estimated survival since clinical diagnosis of malignant ascites with 95% confidence limits.

Overall estimated survival for different types of cancer since clinical diagnosis of malignant ascites.

Overall estimated survival in patients with metastatic ovarian cancer associated with malignant ascites is better if intraperitoneal infusion of catumaxomab through the Tenckhoff catheter is carried out (p = 0.02).

Analysis of overall survival since clinical diagnosis of malignant ascites for different groups of cancers

	Hazard ratio	Lower limit	Upper limit	P-value
Gynaecological cancers (reference)	-	-	-	0.06
Hepatobiliary cancers	1.17	0.68	2.02	0.575
Gastrointestinal cancers	2.58	1.30	5.13	0.007
Gastrointestinal cancers	2.58	1.30	5.13	0.007
Breast cancer	1.42	0.73	2.74	0.299
Rest	0.71	0.25	1.99	0.511

Kaplan-Meier estimates for overall survival since Tenckhoff insertion at specific follow-up times (+95% confidence interval)

Months since Tenckhoff insertion	% Survival	Lower limit	Upper limit
3	30.0	20.9	39.6
6	18.0	10.8	26.8
12	7.7	3.2	14.5
18	2.6	0.3	9.9
24	2.6	0.3	9.9

Kaplan-Meier estimates for overall survival since clinical diagnosis of ascites at specific follow-up times (+ 95% confidence interval)

Months since clinical diagnosis of ascites	% Survival	Lower limit	Upper limit
3	82.2%	72.6%	88.7%
6	63.2%	53.3%	72.2%
12	44.7%	34.1%	54.7%
18	30.6%	21.2%	40.4%
24	24.7%	16.2%	34.1%

Survival analysis in patients with metastatic ovarian cancer and malignant ascites treated with or without intraperitoneal infusion of catumaxomab after Tenckhoff catheter insertion

IPCT	Median survival in months	95% confidence interval

		Lower limit	Upper limit
With IPCT	3.22	1.61	6.58
Without IPCT	1.61	0.69	2.40

Type of primary cancer

Primary malignant disease	Statistic	All
Gynaecological cancer	n/N (%)	41/94 (43.6%)
Ovarian cancer	n/N	38/94
Endometrial cancer	n/N	3/94
Hepatobiliary cancer	n/N (%)	24/94 (25.5%)
Pancreatic cancer	n/N	11/94
Cholangiocarcinoma	n/N	12/94
Hepatocellular carcinoma	n/N	1/94
Gastrointestinal cancer	n/N (%)	11/94 (11.7%)
Colorectal cancer	n/N	6/94
Gastric cancer	n/N	3/94
Small bowel neuroendocrine cancer	n/N	2/94
Breast cancer	n/N (%)	13/94 (13.8%)
Rest	n/N (%)	5/94 (5.3%)

Paracenteses prior to Tenckhoff catheter placement

Number of paracenteses	Statistic	All
0	n/N (%)	19/94 (20.2%)
1	n/N (%)	20/94 (21.3%)
2	n/N (%)	16/94 (17.0%)
3	n/N (%)	15/94 (16.0%)
4 or > 4	n/N (%)	24/94 (25.5%)

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Calendario de la edición:: 4 veces al año
Temas de la revista:: Medicine, Clinical Medicine, Radiology, Internal Medicine, Haematology, Oncology

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