Pleura-peritoneum crosstalk: A Retrospective Study of Malignant Pleural effusions and Ascites in Gynaecological Cancers

<bold>Introduction:</bold> Malignant ascites (MA) is commonly seen with advanced gynaecological cancers. Many of these patients also develop malignant pleural effusions (MPE), however little is known about the correlation between MA and MPE in these patients. <bold>Methods:</bold> We performed a retrospective analysis of all patients referred to the oncology clinic for advanced gynaecological cancer from Jan-Dec'22. MPE and MA were determined by confirmed fluid cytology, or presumed to be malignant with confirmatory histology elsewhere. <bold>Results:</bold> A total of 72 patients were treated with a median age of 70(IQR: 60-79)years, and most had ovarian cancer(88.9%). Most patients(90.3%) had received treatment including chemotherapy alone, or surgery and neo- or adjuvant chemotherapy. At the time of analysis, 32(44.4%) patients had passed away. During the course of disease, 53(73.6%) patients developed MA, with 46(63.9%) patients found to have clinical or radiological evidence of ascites at the time of cancer diagnosis, and 25(34.7%) patients requiring 1 or more therapeutic ascitic drainages. 28(38.9%) patients also developed MPE, of whom 9(32.1%) were left sided, and 13(46.4%) were bilateral. 11 patients required at least one therapeutic chest drainage with 6 patients undergoing indwelling pleural catheter insertions. Among patients with MPE, almost all(27 patients or 96.4%) had presented with, or developed ascites during the course of their disease. Similarly, in 11 patients requiring therapeutic chest drainage, 10(90.9%) patients required at least one therapeutic ascitic drainage. <bold>Conclusion:</bold> MPE in gynaecological cancers is closely associated with MA and ascitic drainage.