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Supportive Care in Cancer

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22.11.2017 | Original Article

Efficacy and safety of reinfusion of concentrated ascitic fluid for malignant ascites: a concept-proof study

verfasst von: Rumi Hanada, Naosuke Yokomichi, Chihiro Kato, Kazumi Miki, Sachiko Oyama, Tatsuya Morita, Ryoko Kawahara

Erschienen in: Supportive Care in Cancer | Ausgabe 5/2018

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Abstract

Purpose

Malignant ascites is one of the symptoms causing discomfort in advanced cancer patients. Cell-free and concentrated ascites reinfusion therapy (CART) is one treatment modality, but controlled trials are limited. The primary aim of this study was to explore the efficacy and safety of CART, as well as their predictors, to obtain data for planning a further controlled trial.

Methods

This was a single center retrospective cohort study in patients with refractory malignant ascites. Consecutive adult patients who underwent CART were enrolled. The primary endpoints were the time to next paracentesis and seven patient-reported symptoms (e.g., abdominal pain and distension). The secondary endpoints were adverse events, laboratory findings, and physical findings.

Results

A total of 104 CART procedures for 51 patients were analyzed. The median time to next paracentesis was 27 days (95% CI, 21–35). Intensities of all seven symptoms were significantly improved after CART (p < 0.0001 for all symptoms). Grade 3 hypotension occurred during one procedure, and mild fever occurred in 5%. Total protein, albumin, and estimated glomerular filtration rate were significantly increased. Hemorrhagic ascites, ascites white blood cell count, serum total protein, and lymphocyte percentages were the independent predictors of the time to next paracentesis.

Conclusion

The effects of reinfusion of concentrated ascitic fluid may be maintained for 1 month, being potentially longer than that of total paracentesis alone. This study had no comparison groups and examined the short-term effect. A randomized controlled study to compare the long-term effects of total paracentesis alone vs. CART is necessary.

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Titel: Efficacy and safety of reinfusion of concentrated ascitic fluid for malignant ascites: a concept-proof study
verfasst von: Rumi Hanada
Naosuke Yokomichi
Chihiro Kato
Kazumi Miki
Sachiko Oyama
Tatsuya Morita
Ryoko Kawahara
Publikationsdatum: 22.11.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 5/2018
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-017-3980-5

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Springer Medizin

Efficacy and safety of reinfusion of concentrated ascitic fluid for malignant ascites: a concept-proof study

Abstract

Purpose

Methods

Results

Conclusion

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Abstract

Purpose

Methods

Results

Conclusion

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