5 Key Takeaways

• 1

  Ovarian cancer spreads rapidly in the abdomen by recruiting and reprogramming protective mesothelial cells in ascites fluid.

• 2

  Epithelial ovarian cancer is often diagnosed at an advanced stage due to its ability to metastasize quickly within the abdominal cavity.

• 3

  Nearly all ovarian cancer cells in ascites form compact spheroids, with about 60% containing mesothelial cells that aid in invasion.

• 4

  Mesothelial cells in cancer–mesothelial spheroids initiate invasion, allowing rapid peritoneal spread without major gene expression changes.

• 5

  The tumor microenvironment in ascites presents a potential therapeutic target to reduce metastatic spread and improve patient outcomes.