Protein Concentration of Refractory Ascites in Cancer Patients is Reflected by the Presence and Severity of Peritoneal and Liver Metastasis

Abstract

Ascites total protein concentration (A-TP) affects the performance of cell-free and concentrated ascites reinfusion therapy (CART). As the factors determining A-TP remain unclear, we examined peritoneal and liver metastasis. Among 98 patients who received CART, 68 with cancer, ascites from no other apparent cause, and complete CT and A-TP data were recruited. Sixty-six patients (97%) with peritoneal and/or liver metastasis on CT were divided into the peritoneal metastasis group (PM group), peritoneal and liver metastasis group (PM + LM group), and liver metastasis group (LM group). A-TP was highest in the PM group (3.9 g/dL [3.4-4.4]), lowest in the LM group (1.0 g/dL [0.9-2.0]), and broadly dispersed in the PM + LM group (3.3 g/dL [2.0-3.8]). All differences were statistically significant. The percentage of metastasis volume occupying the liver was negatively and significantly related to A-TP in the PM + LM group. Taken together, the presence and severity of peritoneal and liver metastasis may influence A-TP.

Verification of serum albumin elevating effect of cell-free and concentrated ascites reinfusion therapy for ascites patients: a retrospective controlled cohort study

“…Refractory ascites patients often develop hypoalbuminemia due reasons such as protein leakage into ascites 1 and body protein consumption by underlying diseases 2,3 . Since albumin is essential for the maintenance of colloid osmotic pressure, hypoalbuminemia can cause systemic swelling, intravascular dehydration, and prerenal failure 4–6 .…”

“…Ascites drainage by paracentesis is performed as a general non-drug treatment for refractory ascites 17,18 . During simple paracentesis, hypoalbuminemia may develop since large amounts of protein are drained and discarded 1 . To prevent hypoalbuminemia by the loss of ascites protein 19 , cell-free and concentrated ascites reinfusion therapy (CART) was developed in Japan in the 1970s 20 .…”

Biochemical evaluation of processed ascites in patients undergoing cell‐free and concentrated ascites reinfusion therapy

“…Therefore, we consider the increase in 2.0 g/dL of albumin to be sufficient, even though the differences were not significant in the present study. In another study, Yamada et al also demonstrated that total protein concentration in ascites could be determined by the presence with or without peritoneal or liver metastasis 11 . It is important to know these simultaneous comorbidities because we can assume the levels of total protein concentration ahead of paracentesis.…”

Evaluation of the performance, operability, and safety of Plasauto μ, a new type of machine for cell‐free and concentrated ascites reinfusion therapy, in a postmarketing clinical study

“…In recent years, cell‐free and concentrated ascites reinfusion therapy (CART) has been widely used for malignant ascites in Japan [ 1 , 2 , 3 , 4 ]. This process is carried out by collecting the ascites from the patient followed by its filtration and concentration.…”