title: Efficacy and safety of cell-free and concentrated ascites reinfusion therapy (CART) in gynecologic cancer patients with a large volume of ascites.
abstract: OBJECTIVE
  The aim of this study was to evaluate the efficacy and safety of cell-free concentrated ascites reinfusion therapy (CART) on a large amount of ascites.
  
  
  METHODS
  Fifty-eight CART procedures were performed in nine patients with ovarian, endometrial, or cervical cancer from February 2013 to September 2014. The medical records were retrospectively reviewed for the amount of collected ascites, vital signs, and laboratory results before and after CART.
  
  
  RESULTS
  No obvious change in the plasma protein and plasma albumin concentration was found after CART for < 5 L of ascites; however, obvious increases in both were observed in CART for ≥ 5 L of ascites (P < 0.001). The optimum cut-off value for obtaining a positive variant of plasma protein and plasma albumin after CART was 7.9 L. CART for ≥ 5 L of ascites did not increase the risk of transient water retention in the body (odds ratio = 2.2; 95% confidence interval: 0.35-13.83; P = 0.38); however, CART for ≥ 7.9 L of ascites increased the risk of water retention (odds ratio = 8.4; 95% confidence interval: 1.91-44.09; P = 0.004). The optimal cut-off value of ascites for predicting water retention due to CART was 9.2 L.
  
  
  CONCLUSIONS
  Massive ascites collection in CART < 9.2 L appears to be a safe and effective treatment for improving general condition, plasma protein, and electrolytes in gynecologic cancer patients.
authors.affiliation: Department of Obstetrics and Gynecology, Sekishindo Hospital, Saitama, Japan.|Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Liangcheng
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Obstetrics and Gynecology, Sekishindo Hospital, Saitama, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Okubo
authors.affiliation: Department of Obstetrics and Gynecology, Sekishindo Hospital, Saitama, Japan.
authors.forename: Mamiko
authors.initials: M
authors.lastname: Shinsaka
authors.affiliation: Department of Obstetrics and Gynecology, Sekishindo Hospital, Saitama, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Kobayashi
authors.affiliation: Department of Obstetrics and Gynecology, Sekishindo Hospital, Saitama, Japan.
authors.forename: Miwa
authors.initials: M
authors.lastname: Ogasawara
authors.affiliation: Department of Obstetrics and Gynecology, Sekishindo Hospital, Saitama, Japan.
authors.forename: Riko
authors.initials: R
authors.lastname: Sakaguchi
authors.affiliation: Department of Obstetrics and Gynecology, Sekishindo Hospital, Saitama, Japan.|Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Nagai
authors.affiliation: Department of Obstetrics and Gynecology, Sekishindo Hospital, Saitama, Japan.|Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Seki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000209:etiology / Q000628:therapy*; D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications*; D006801:Humans; D007263:Infusions, Parenteral / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies
keywords: ascites; gynecology; neoplasms; paracentesis