529MO - Cell-free concentrated ascites reinfusion therapy (CART) followed by chemotherapy for the patients with cancerous ascites: A case control study from a single institution in Japan

Background

Cell-free concentrated ascites reinfusion therapy (CART) is a blood purification therapy to remove unnecessary components from drained ascites, and to infuse the concentrated substances back to patients. CART is used for refractory ascites, including ascites due to cancerous peritonitis. The prognosis of patients with cancerous ascites is generally poor, and best supportive care (BSC) is chosen. Some received chemotherapy after ascites were removed with CART, but its efficacy and clinical outcomes remain unclear. The purpose of this study was to investigate the outcome of the patients who received chemotherapy after CART.

Methods

We retrospectively reviewed patients with cancerous ascites who received CART in our hospital from June 2015 to April 2021. Overall survival (OS) was defined as the time from initiation of CART to death. We compared the OS with and without chemotherapy after CART, and clinical features were statistically analyzed to reveal prognostic factors.

Results

A total of 59 patients had CART due to cancerous ascites, and 17 patients subsequently received chemotherapy. Of the 17 cases, 47% were more than 65 years-old, and 24% had PS 2-4. The primary diagnosis was 35% with gastric, 18% with colorectal, 12% with breast, 6% with uterine, 18% with ovarian, 12% with other cancer. 65% received chemotherapies previously when CART was introduced. CART was conducted more than twice in 59% of the patients, and 4 patients received irinotecan which is generally contraindicated for the patients with ascites. The characteristics of the patient including laboratory data between the groups with and without chemotherapy were not significantly different, expect for PS. OS for the patients who received chemotherapy after CART was 308 days (95%CI: 173-1402) compared to 32 days (95%CI: 18-50) (p<0.001) for those without chemotherapy.

Conclusions

The patients with chemotherapy after CART could expect longer OS than those without chemotherapy. Besides BSC, CART followed by chemotherapy might be a possible option for the patients with cancerous ascites.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.