Malignant Ascites in Ovarian Cancer: Cellular, Acellular, and Biophysical Determinants of Molecular Characteristics and Therapy Response

Ascites refers to the abnormal accumulation of fluid in the peritoneum resulting from an underlying pathology, such as metastatic cancer. Among all cancers, advanced-stage epithelial ovarian cancer is most frequently associated with the production of malignant ascites and is the leading cause of dea...

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Bibliographic Details
Published in:Cancers 2021-08, Vol.13 (17), p.4318
Main Authors: Rickard, Brittany P, Conrad, Christina, Sorrin, Aaron J, Ruhi, Mustafa Kemal, Reader, Jocelyn C, Huang, Stephanie A, Franco, Walfre, Scarcelli, Giuliano, Polacheck, William J, Roque, Dana M, Del Carmen, Marcela G, Huang, Huang-Chiao, Demirci, Utkan, Rizvi, Imran
Format: Article
Language:English
Subjects:
Ascites
Cancer therapies
Chemotherapy
Fallopian tubes
Gene expression
Immunology
Kinases
Medical prognosis
Metastases
Metastasis
Morphology
Mortality
Mutation
Ovarian cancer
Pathophysiology
Patients
Peritoneal fluid
Peritoneum
Proteins
Review
Tumors
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Summary:Ascites refers to the abnormal accumulation of fluid in the peritoneum resulting from an underlying pathology, such as metastatic cancer. Among all cancers, advanced-stage epithelial ovarian cancer is most frequently associated with the production of malignant ascites and is the leading cause of death from gynecologic malignancies. Despite decades of evidence showing that the accumulation of peritoneal fluid portends the poorest outcomes for cancer patients, the role of malignant ascites in promoting metastasis and therapy resistance remains poorly understood. This review summarizes the current understanding of malignant ascites, with a focus on ovarian cancer. The first section provides an overview of heterogeneity in ovarian cancer and the pathophysiology of malignant ascites. Next, analytical methods used to characterize the cellular and acellular components of malignant ascites, as well the role of these components in modulating cell biology, are discussed. The review then provides a perspective on the pressures and forces that tumors are subjected to in the presence of malignant ascites and the impact of physical stress on therapy resistance. Treatment options for malignant ascites, including surgical, pharmacological and photochemical interventions are then discussed to highlight challenges and opportunities at the interface of drug discovery, device development and physical sciences in oncology.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers13174318