Introduction/Background Concentrated ascites reinfusion therapy (CART) is currently applied widely to relieve symptoms in patients with malignant ascites. However, only few studies have investigated the ability of CART to improve or maintain quality of life (QOL). Therefore, we performed a prospective cohort study to evaluate the efficacy and safety of CART.

Methodology From April 2018 to March 2019, 22 patients with gynecological malignancies received CART. We performed QOL assessment using the Japanese version of the M.D. Anderson Symptom Inventory (MDASI-J) at 24 h before and after CART.

Results The 22 patients received a total of 41 CART sessions. This included 16 patients with epithelial ovarian cancer, 5 with peritoneal cancer, and 1 with fallopian tube cancer. CART was performed 24 times before or during neoadjuvant chemotherapy, twice before primary debulking surgery, and 15 times during chemotherapy to prevent recurrence. The mean amount of ascites collected was 2.9 L (0.75–6 L). The concentrations of total protein and albumin were maintained before and after CART (2.5 ± 0.58 g/dL and 2.8 ± 1.72 g/dL, respectively). The most common adverse event was fever [63.6% (14/22 patients) and 39.0% (16/41 sessions)], which is easily controllable by NSAIDs. No patient experienced severe adverse events. CART improved the symptom and interference scores of the MDASI-J significantly within 24 h of the procedure. Various symptoms associated with malignant ascites, especially appetite loss and fatigue, improved within the 24-h period following CART. The mean symptom scores of the MDASI-J decreased from 3.3 to 2.5, and the interference scores of the MDASI-J decreased from 5.2 to 4.

Conclusion CART is an effective and relatively safe procedure for malignant ascites in patients with gynecologic cancer. In particular, QOL scores were improved by CART.

Disclosure Nothing to disclose