Introduction: Malignant Ascites (MA) is a serious complication of gastrointestinal cancers that significantly reduces quality of life and is associated with a poor prognosis. Its pathophysiology involves several mechanisms, including increased vascular permeability, venous compression, and lymphatic vessel infiltration. Material and methods: A literature review was conducted using the PubMed database, covering the years 2017–2025. Search phrases such as “malignant ascites” and “symptomatic treatment of ascites” were used. The review included clinical and review studies focusing on patients with MA associated with gastrointestinal cancers. Studies on ascites of other etiologies and preclinical research were excluded. Results: The most commonly used symptomatic treatment methods include paracentesis, diuretic therapy, peritoneovenous shunts, indwelling catheters, and intraperitoneal chemotherapy. Each method has its own advantages and limitations. Modern techniques such as HIPEC, immunotherapy, and photothermal therapy show promising results in preliminary studies. Conclusion: Malignant ascites requires an individualized therapeutic approach. It is essential to combine treatment efficacy with improvements in patients’ quality of life. Further research is needed to develop optimal strategies for symptomatic management.
Skowron et al. (Tue,) studied this question.