Systemic chemotherapy after ascites diagnosis was associated with a significantly longer median OS compared with BSC alone according to univariate analysis (HR: 0.27, 95% CI 0.17-0.43, P < 0.001), which remained significant (HR: 0.35, 95% CI 0.20-0.61, P < 0.001) when corrected for potential confounders from univariate analysis within multivariate analysis such as ECOG PS (P > 0.05), metastatic sites (liver: HR: 2.07, 95% CI 1.13-3.79, P = 0.018, peritoneum: HR: 1.74, 95% CI 1.11-2.71, P = 0.015), PVO (HR: 2.52, 95% CI 1.29-4.90, P = 0.007), albumin (P > 0.05) or the ALBI score (P > 0.05). Here, ALB is linked to Ascites.