Yuji Tanaka

Intraoperative Collection of Ascitic Fluid With Intra‐ or Postoperative Reinfusion in Ovarian Cancer: Safety and Feasibility of a Roller Pumping Method

ABSTRACT Introduction Patients with ovarian cancer often present with massive ascites, leading to significant protein loss during surgical procedures. Although cell‐free concentrated ascites reinfusion therapy (CART) is used in palliative settings to mitigate protein loss, its application in intraoperative settings remains unexplored. Methods We retrospectively evaluated patients who underwent intraoperative CART for ovarian cancer treatment between March 2022 and 2025, compared two ascitic fluid collection methods (syringe and roller pumping), and analyzed operative parameter, fluid collection efficiency, albumin recovery, and adverse event‐related data. Results Among the 12 patients included in this study, seven (58.3%) underwent CART using the roller pumping method, which significantly reduced the collection time compared with the syringe method (9 vs. 22 min, p  < 0.05). The median collection speed was also significantly higher with the roller pumping method (404 vs. 140 mL/min, p  < 0.05). Approximately 70% of the albumin in the collected ascitic fluid was successfully reinfused. Adverse events included transient hypotension (16.7%) and hypertension (25.0%), both of which resolved without intervention. Conclusion Intraoperative CART is a feasible and safe technique for protein loss management in patients undergoing surgery for ovarian cancer. The roller pumping method significantly shortened ascites collection time and reduced surgical burden.

mTOR inhibitors potentially preserve fertility in female patients with haematopoietic malignancies: a narrative review

Balancing Fertility Preservation and Treatment Efficacy in (Neo)adjuvant Therapy for Adolescent and Young Adult Breast Cancer Patients: a Narrative Review

Long Term Disease Control of Brain Metastases From Chemotherapy‐Resistant Endometrial Cancer With Lenvatinib and Pembrolizumab: A Case Report

ABSTRACT Brain metastases from endometrial carcinoma are extremely rare and associated with poor prognosis. We present a 43‐year‐old woman with mismatch repair deficient endometrial cancer who developed multiple brain metastases refractory to cytotoxic chemotherapy and without extracranial involvement. After stereotactic radiotherapy, combination therapy with lenvatinib and pembrolizumab resulted in sustained partial remission for 16 months, with no evidence of brain hemorrhage. This case demonstrates that lenvatinib plus pembrolizumab may offer an effective and safe therapeutic option for brain metastases from endometrial cancer, even in patients resistant to conventional therapy. Remarkably, this outcome challenges the traditionally poor prognosis of such cases and underscores the potential for novel targeted and immunotherapeutic strategies to redefine the standard of care for this rare and devastating complication.

Duodenal stenosis due to small lymphocele after para-aortic lymphadenectomy: A case report and review of the literature

We present an unusual case of a small para-aortic lymphocele causing duodenal stenosis after lymphadenectomy and discuss its treatment. Our case involved a 57-year-old woman with endometrial cancer who underwent surgery, including para-aortic lymphadenectomy. On postoperative day 7, projectile vomiting occurred. Computed tomography (CT) revealed a small lymphocele in the dorsal duodenum, causing duodenal stenosis. Transpercutaneous and transduodenal puncture or surgical procedures were difficult because the cyst was too small. Per endoscopic and gastrointestinal series findings on the postoperative day 22, a liquid diet was presumed to be able to pass through the narrow portion. Hence, concentrated liquid food was administered orally; no vomiting occurred. At 2 months postoperatively, CT showed no lymphocele. Conservative treatment involving waiting for spontaneous lymphocele reduction with a concentrated fluid diet may be considered in such cases if fluid passage is confirmed with endoscopy and gastrointestinal series.