Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
International Journal of Clinical Oncology
Published in: International Journal of Clinical Oncology 4/2019

01-04-2019 | Original Article

Usefulness of cell-free and concentrated ascites reinfusion therapy in the therapeutic management of advanced ovarian cancer patients with massive ascites

Authors: Yoshiko Kawata, Kazunori Nagasaka, Yoko Matsumoto, Katsutoshi Oda, Michihiro Tanikawa, Kenbun Sone, Mayuyo Mori-Uchino, Tetsushi Tsuruga, Takahide Arimoto, Yutaka Osuga, Tomoyuki Fujii

Published in: International Journal of Clinical Oncology | Issue 4/2019

Login to get access

Abstract

Background

The management of refractory ascites in advanced ovarian cancer (AOC) is vital for patients with abdominal distention, respiratory distress, and anorexia due to massive ascites with cancer peritonitis. We analyzed the benefits of concentrated ascites reinfusion therapy (CART) in the management of AOC.

Methods

We reviewed records of AOC patients who underwent CART between January 2011 and March 2017. We retrospectively analyzed patients’ backgrounds and physiological changes, including body weight, abdominal girth, urine volume, blood component values, blood pressure, heart rate, and body temperature before and after CART. We investigated the clinicopathological significance of CART by measuring the mean number of ascites tumor cell (ATC) clusters before CART.

Results

A retrospective analysis was performed on 29 cases of AOC with massive ascites involving 47 CART sessions. The patients’ mean age was 56.6 ± 12.8 years, and the mean number of sessions was 1.7 ± 1.2. The mean volume of the processed ascites was 2,937 ± 820 mL, which was concentrated to 272 ± 84 mL containing 85.0 ± 33.2 g protein on average. Significant reductions in abdominal girth (− 5.30 ± 0.65 cm; p < 0.0001) and body weight (− 2.97 ± 0.26 kg; p = 0.0011), increased urine volume (+ 824.29 ± 145.21 mL; p < 0.0001), and improved serum albumin levels (+ 0.18 ± 0.34; p < 0.0001) were observed after CART. Analysis of variance revealed significant elevations in body temperature after CART in 11 patients with a small number of ATC clusters.

Conclusions

CART is useful for the therapeutic management of AOC patients with refractory massive ascites. Elevations of body temperature after CART may be avoided by the investigation of patients’ peritoneal cytology before CART.
Literature
1.
2.
3.
Becker G, Galandi D, Blum HE (2006) Malignant ascites: systematic review and guideline for treatment. Eur J Cancer 42:589–597CrossRefPubMed
4.
Cavazzoni E, Bugiantella W, Graziosi L et al (2013) Malignant ascites: Pathophysiology and treatment. Int J Clin Oncol 18:1–9CrossRefPubMed
5.
Ahmed N, Stenvers KL (2013) Getting to know ovarian cancer ascites: Opportunities for targeted therapy-based translational research. Front Oncol 3:1–12CrossRef
6.
Meier M, Mortensen FV, Madsen HHT (2015) Malignant ascites in patients with terminal cancer is effectively treated with permanent peritoneal catheter. Acta Radiol Open 4:2058460115579934PubMedCentralPubMed
7.
Gotlieb WH, Feldman B, Feldman-Moran O et al (1998) Intraperitoneal pressures and clinical parameters of total paracentesis for palliation of symptomatic ascites in ovarian cancer. Gynecol Oncol 71:381–385CrossRefPubMed
8.
Lee CW, Bociek G, Faught W (1998) A survey of practice in management of malignant ascites. J Pain Symptom Manage 16:96–101CrossRefPubMed
9.
10.
Ueda T, Maehara M, Takahashi Y et al (2012) Clinical significance of cell-free and concentrated ascites re-infusion therapy for advanced and recurrent gynecological cancer. Anticancer Res 32:2353–2358PubMed
11.
Inoue N, Yamazaki Z, Oda T et al (1977) Treatment of intractable ascites by continuous reinfusion of the sterilized cell-free and concentrated ascitic fluid. Trans Am Soc Artif Intern Organs 23:699–702CrossRefPubMed
12.
Kozaki K, IInuma M, Takagi T et al (2016) Cell-free and concentrated ascites reinfusion therapy for decompensated liver cirrhosis. Ther Apher Dial 20:376–382CrossRefPubMed
13.
Katoh S, Kojima T, Itoh K et al (1997) Usefulness of a nonmachinery based system for the reinfusion of cell-free and concentrated autogenous ascitic fluid. Artif Organs 21:1232–1238CrossRefPubMed
14.
Japanese CART Study Group, Matsusaki K, Ohta K, Yoshizawa A et al (2011) Novel cell-free and concentrated ascites reinfusion therapy (KM-CART) for refractory ascites associated with cancerous peritonitis: its effect and future perspectives. Int J Clin Oncol 16:395–400CrossRef
15.
Yamaguchi H, Kitayama J, Emoto S et al (2015) Cell-free and concentrated ascites reinfusion therapy (CART) for management of massive malignant ascites in gastric cancer patients with peritoneal metastasis treated with intravenous and intraperitoneal paclitaxel with oral S-1. Eur J Surg Oncol 41:875–880CrossRefPubMed
16.
Orimi S, Mizuno K, Narahara M et al (2011) A study of appropriate flow rate settings for cell-free and concentrated ascites reinfusion therapy and change of cytokine concentrations in ascites. Ther Apher Dial 15:411–414CrossRefPubMed
17.
Wang L, Okubo T, Shinsaka M et al (2015) Efficacy and safety of cell-free and concentrated ascites reinfusion therapy (CART) in gynecologic cancer patients with a large volume of ascites. J Obstet Gynaecol Res 41:1614–1620CrossRefPubMed
18.
Ito T, Hanafusa N, Fukui M et al (2014) Single center experience of cell-free and concentrated ascites reinfusion therapy in malignancy related ascites. Ther Apher Dial 18:87–92CrossRefPubMed
19.
Hanafusa N, Isoai A, Ishihara T et al (2017) Safety and efficacy of cell-free and concentrated ascites reinfusion therapy (CART) in refractory ascites: post-marketing surveillance results. PLoS One 12:1–21CrossRef
20.
21.
Maeda O, Ando T, Ishiguro K et al (2014) Safety of repeated cell–free and concentrated ascites reinfusion therapy for malignant ascites from gastrointestinal cancer. Mol Clin Oncol 2:1103–1106CrossRefPubMedCentralPubMed
22.
Maeda S, Yabuuchi J, Nobuta H et al (2015) Characteristics of patients and their ascites who underwent repeated cell-free and concentrated ascites reinfusion therapy. Ther Apher Dial 19:342–348CrossRefPubMed
23.
Layfield LJ, Mooney EE, Glasgow B et al (1997) What constitutes an adequate smear in fine-needle aspiration cytology of the breast? Cancer 81:16–21CrossRefPubMed
24.
Oken MM, Creech RH, Tormey DC et al (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5:649–655CrossRefPubMed
25.
Okuyama T, Wang XS, Akechi T et al (2003) Japanese version of the M.D. Anderson Symptom Inventory: a validation study. J Pain Symptom Manage 26:1093–1104CrossRefPubMed
26.
Siegel RL, Miller KD, Jemal A (2018) Cancer statistics, 2018. CA Cancer J Clin 68:7–30CrossRef
27.
Malvezzi M, Carioli G, Rodriguez T et al (2016) Global trends and predictions in ovarian cancer mortality. Ann Oncol 27:2017–2025CrossRefPubMed
28.
Agarwal R, Kaye SB (2003) Ovarian cancer: strategies for overcoming resistance to chemotherapy. Nat Rev Cancer 3:502CrossRefPubMed
29.
30.
31.
Nakajima F, Shibahara N, Oka H et al (2001) Relationship between IL-6 levels and fever during ascites reinfusion therapy. Nihon Toseki Igakkai Zasshi 34:335–338CrossRef
32.
Kalra A, Wedd JP, Bambha KM et al (2017) Neutrophil-to-lymphocyte ratio correlates with proinflammatory neutrophils and predicts death in low model for end-stage liver disease patients withcirrhosis. Liver Transpl 23:155–165CrossRefPubMedCentralPubMed
33.
Nagasaka K, Kawana K, Tomio K et al (2015) Positive peritoneal cytology at interval surgery is a poor prognostic factor in patients with stage T3c advanced ovarian carcinoma: a retrospective study. J Obstet Gynaecol Res 41:755–762CrossRefPubMed
Metadata
Title
Usefulness of cell-free and concentrated ascites reinfusion therapy in the therapeutic management of advanced ovarian cancer patients with massive ascites
Authors
Yoshiko Kawata
Kazunori Nagasaka
Yoko Matsumoto
Katsutoshi Oda
Michihiro Tanikawa
Kenbun Sone
Mayuyo Mori-Uchino
Tetsushi Tsuruga
Takahide Arimoto
Yutaka Osuga
Tomoyuki Fujii
Publication date
01-04-2019
Publisher
Springer Singapore
Published in
International Journal of Clinical Oncology / Issue 4/2019
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-018-1371-7

Other articles of this Issue 4/2019

International Journal of Clinical Oncology 4/2019 Go to the issue

Original Article

Feasibility of the imatinib stop study in the Japanese clinical setting: delightedly overcome CML expert stop TKI trial (DOMEST Trial)

Original Article

Prognostic impact of underlying lung disease in pulmonary wedge resection for lung cancer

Original Article

Genetic association of promoter in GRP78 gene with nasopharyngeal carcinoma in a Chinese population

Review Article

Survivin rs9904341 polymorphism significantly increased the risk of cancer: evidence from an updated meta-analysis of case–control studies

Original Article

Lymphopenia after induction chemotherapy correlates with incomplete surgical resection in patients with advanced ovarian cancer

Original Article

The effects of intraoperative ICG fluorescence angiography in laparoscopic low anterior resection: a propensity score-matched study
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits