[A New Treatment Strategy-Novel Cell-Free and Concentrated Ascites Reinfusion System(KM-CART)for Massive Malignant Ascites].

Massive ascites associated with cancerous peritonitis can result in severe respiratory discomfort and abdominal fullness. Additionally, it can significantly impair the activities of daily living of a patient, and relaxation is difficult to achieve, even with opioids. Frequent ascites drainage can cause rapid worsening of the patient's general condition, and a large amount of ascites can lead to discontinuation of anti-cancer treatment. Cell-free and concentrated ascites reinfusion therapy(CART)for refractory ascites was first covered by the insurance system in 1981. However, cancerous ascites includes many cellular components as well as mucus, and purification was a difficult process. Therefore, since the 1990s, CART disappeared from the field of cancer treatment. I have devised a Keisuke Matsusaki(KM)-CART system that has the ability to clean the filtration membrane. This system enables purification of massive cancerous ascites that may exceed 20 L. The general condition of the patients and their symptoms improve after use of KM-CART, making it possible to initiate or resume anti-cancer therapy. KM-CART helps remove unwanted components, such as cancer cells, cytokines, and vascular endothelial growth factors from the abdominal cavity through filtration of drained ascites. Therefore, the peritoneal environment can be improved, leading to enhancement of the efficacy of intraperitoneal chemotherapy. In addition, a large number of cancer cells and lymphocytes can be obtained with KM-CART, and it is possible to use these cells for customized cancer treatments, such as dendritic cell vaccine therapy, and to perform anti-cancer agent susceptibility testing. I believe that KM-CART is a good treatment approach for massive ascites associated with cancerous peritonitis.