Cytokine dynamics and quality of life: unraveling the impact of cell-free and concentrated ascites reinfusion therapy in ovarian cancer patients

Sep 23, 2026

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Quality of life in ovarian cancer patients is frequently worsened by refractory ascites, and CART is used as palliative therapy despite troublesome adverse events such as fever. This study comprehensively examined cytokines in ascites fluid and serum before and after CART to clarify links with safety and efficacy. Findings showed transient cytokine elevations with a short-lived inflammatory response, alongside temporary fever and improved QOL after treatment, supporting CART’s safety and effectiveness.

LanguageEnglish

CategoryHealthcare

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Pages11

Reading Time28 min

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Abstract

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Introduction

International Journal of Clinical Oncology (2025) 30:559–569 [https://doi.org/10.1007/s10147-024-02682-1](https://doi.org/10.1007/s10147-024-02682-1) Cytokine dynamics and quality of life: unraveling the impact of cell‑free and concentrated ascites reinfusion therapy in ovarian cancer patients Rikako Ito1 · Masahiro Kagabu1 · Sho Sato1 · Eriko Takatori1 · Yoshitaka Kaido1 · Takayuki Nagasawa1 · Tadahiro Shoji1 · Takashi Hirayama2 · YasuhisaTerao2 · Tsukasa Baba1 Received: 7 October 2024 / Accepted: 9 December 2024 / Published online: 4 January 2025 © The Author(s) 2024 Abstract Background The quality of life (QOL) of ovarian cancer patients is often impaired by refractory ascites. Cell-free and concentrated ascites reinfusion therapy (CART) is a palliative treatment for refractory ascites, but adverse events, such as fever, are problematic. Several cytokines have been suggested to be responsible for the adverse events, but they have not been investigated in detail. Thus, we comprehensively analyzed cytokines in ascites fluid (AF) and serum before and after CART to determine the influence of cytokines on the safety and efficacy of CART. Methods Thirteen ovarian cancer patients with refractory malignant ascites who underwent CART were enrolled. We comprehensively analyzed 27 cytokines in AF and serum before and after CART. Simultaneously, vital measurements, blood tests, adverse event recordings, and QOL assessments were performed to examine the relationships between the cytokines in AF and serum. Results Interleukin (IL)-5, IL-6, IL-10, and monocyte chemoattractant protein-1 levels were increased in the concentrated AF and in the serum immediately after reinfusion, but they decreased after 24 h. Body temperature also increased immediately after reinfusion, and decreased after 24 h. The CRP level at 24 h after reinfusion was increased, and was positively correlated with the IL-6 level. A QOL assessment using the Cancer Fatigue Scale revealed significantly lower scores after CART. Conclusions The results indicate that the cytokine-induced fever and increased inflammatory response after CART were temporary, and that CART is safe. Additionally, QOL improved after CART. Thus, CART appears safe and effective for treating patients with refractory cancerous ascites. Keywords Cell-free and concentrated ascites reinfusion therapy · Cytokine · Ovarian cancer · Interleukin-6 · Malignancy · Quality of life Introduction According to the 2022 GLOBOCAN Global Cancer Women’s Cancer Data, ovarian cancer is the eighth most common cancer among women worldwide, and with a 5-year survival rate of 30–50%, it has the highest mortality rate * Masahiro Kagabu[mkagabu@iwate-med.ac.jp](mkagabu@iwate-med.ac.jp) 1 Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 2-1-1, Idaidori, Yahaba, Iwate 028-3695, Japan 2 Department of Obstetrics and Gynecology, Faculty of Medicine, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo, Japan among gynecological tumors [1] . In general, the prognosis for ovarian cancer is poor, because the disease is often diagnosed at an advanced stage. Many patients with ovarian, fallopian tube, and/or peritoneal cancer (hereafter called “ovarian cancer patients”) develop refractory ascites as their disease progresses. A significant increase in ascites causes symptoms, such as abdominal distention, anorexia, and dyspnea, leading to poor quality of life (QOL) [2 , 3] . Therefore, to maintain QOL for patients with advanced ovarian cancer, it is important to control refractory ascites. Most patients with advanced ovarian cancer eventually become resistant to chemotherapy and present with refractory ascites, often requiring repeated abdominal paracentesis to relieve symptoms [4] . More recently, cell-free and concentrated ascites reinfusion therapy (CART) has gained recognition as a treatment for patients with refractory ascites. In CART, ascites fluid (AF) is collected an

FAQs

What is CART and why is it used for ovarian cancer with refractory ascites?

CART collects and filters ascites fluid, concentrates remaining albumin and proteins, and returns them intravenously. It aims to relieve symptoms and improve quality of life in patients with refractory ascites.

How did cytokine levels change after CART?

Interleukin-5, interleukin-6, interleukin-10, and monocyte chemoattractant protein-1 increased in concentrated ascites fluid and rose in serum immediately after reinfusion, then decreased after 24 hours.

Did CART affect fever, inflammation, and quality of life?

Body temperature increased immediately after reinfusion and declined after 24 hours. CRP at 24 hours increased and correlated positively with IL-6, while QOL assessment showed significantly lower scores after CART, with improved outcomes reported overall.

Sep 23, 2026

Uploaded by Aria