Ken Ishitani1,2, Ayako Isoai3, Tetsuya Ito4, Hiroshi Sugiyama5, Atsushi Arakawa6, Yosuke Yamada7, Hirokazu Onodera3, Ryosuke Kobayashi3, Naoko Torii3, Noriko Soneda3, Yoshihiro Matsuno3, Taiju Utsugisawa8, Michio Kato9, Norio Hanafusa10. 1. Department of Gynecology, Kitasato University Kitasato Institute Hospital, 5-9-1, Shirokane, Minato-ku, Tokyo, 108-8642, Japan. ishitani@insti.kitasato-u.ac.jp. 2. Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Tokyo, Japan. ishitani@insti.kitasato-u.ac.jp. 3. Blood Purification Division, Asahi Kasei Medical Co., Ltd, Tokyo, Japan. 4. Department of Palliative Care, Japanese Red Cross Medical Center, Tokyo, Japan. 5. Department of Gastroenterology, Kizawa Memorial Hospital, Gifu, Japan. 6. Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. 7. Division of Nephrology, Shinshu University Hospital, Nagano, Japan. 8. Department of Transfusion Medicine and Cell Processing, Tokyo Women's Medical University, Tokyo, Japan. 9. Kato Michio Clinic of Liver Diseases, Hyogo, Japan. 10. Department of Blood Purification, Tokyo Women's Medical University, Tokyo, Japan.
Abstract
BACKGROUND: Cell-free and concentrated ascites reinfusion therapy (CART) has been suggested to be able to treat malignant ascites more safely and effectively with chemotherapy because of its ability to retain serum protein and albumin. Although the characteristics of cancer types and CART and the clinical implications of combination therapy with antitumor agents are becoming widespread, there are limited reports on its efficacy and complications. METHODS: In this prospective observational national post-marketing study, 128 patients with malignancies received 300 CART sessions at 22 centers. After excluding other malignancies, the patients were divided into four groups: gynecological malignancies with chemotherapy (GYC+; 18 cases and 36 times) and without chemotherapy (GYC-; 35 cases and 52 times), and gastrointestinal malignancies with chemotherapy (GIC+; 8 cases and 16 times) and without chemotherapy (20 cases and 58 times). RESULTS: There were significant reductions in the body weight in all groups and significant reductions in abdominal circumference and significant improvements in the diet and Eastern Cooperative Oncology Group performance status only in the GYC+ group. The total serum protein and albumin increased significantly in all groups, except for the GIC+ group, before and after CART. There was no significant difference in the presence or absence of antitumor medication. CONCLUSION: With CART, there were differences in the improvement of the clinical symptoms between malignancy groups. The combination of CART and antineoplastic agents may be as safe as CART alone in cases of exudative malignant ascites.
BACKGROUND: Cell-free and concentrated ascites reinfusion therapy (CART) has been suggested to be able to treat malignant ascites more safely and effectively with chemotherapy because of its ability to retain serum protein and albumin. Although the characteristics of cancer types and CART and the clinical implications of combination therapy with antitumor agents are becoming widespread, there are limited reports on its efficacy and complications. METHODS: In this prospective observational national post-marketing study, 128 patients with malignancies received 300 CART sessions at 22 centers. After excluding other malignancies, the patients were divided into four groups: gynecological malignancies with chemotherapy (GYC+; 18 cases and 36 times) and without chemotherapy (GYC-; 35 cases and 52 times), and gastrointestinal malignancies with chemotherapy (GIC+; 8 cases and 16 times) and without chemotherapy (20 cases and 58 times). RESULTS: There were significant reductions in the body weight in all groups and significant reductions in abdominal circumference and significant improvements in the diet and Eastern Cooperative Oncology Group performance status only in the GYC+ group. The total serum protein and albumin increased significantly in all groups, except for the GIC+ group, before and after CART. There was no significant difference in the presence or absence of antitumor medication. CONCLUSION: With CART, there were differences in the improvement of the clinical symptoms between malignancy groups. The combination of CART and antineoplastic agents may be as safe as CART alone in cases of exudative malignant ascites.
Entities:
Keywords:
Ascites; Cell-free and concentrated ascites reinfusion therapy; Gynecological malignancy