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

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.