Cell-free and Concentrated Ascites Reinfusion Therapy (CART) Shows Enhanced Efficacy in Gynecological Cancer Patients: A Post-marketing Surveillance Study

Background: Cell-free and concentrated ascites reinfusion therapy (CART) is an established method for managing malignant ascites. Ascites management is particularly important for gynecological cancer patients as ovarian cancer is the most common cause of malignant ascites, and patients with gynecological cancers often require long-term treatment. This study evaluates the efficacy and safety of CART specifically in gynecological cancer patients compared to patients with other cancers. Methods: This subgroup-analysis of a prospective post-marketing surveillance was conducted between January 2014 and January 2015. The study included 147 patients who underwent 356 CART sessions across 22 centers in Japan. After excluding non-cancerous patients, subjects were divided into two groups: gynecological cancer patients (Group G) and other cancer patients (Group O). Results: The final analysis included 128 patients who underwent 300 CART sessions (Group G: 46 patients/85 sessions; Group O: 79 patients/211 sessions). Group G had significantly higher rates of concurrent chemotherapy. The amount of total protein and albumin in both original and processed ascites was significantly larger in Group G. Group G showed significant improvements in renal function parameters (serum creatinine, blood urea nitrogen, estimated glomerular filtration rate) and increased daily urine volume. The interval between ascites removal procedures was longer in Group G, and no severe adverse events were observed in either group. Conclusion: CART demonstrates particular efficacy and safety in gynecological cancer patients. The improvement in renal function observed in this study may help reduce side effects of anticancer drugs, potentially contributing to better tolerability.