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Meeting the challenge of ascites in ovarian cancer: new avenues for therapy and research

Nature Reviews Cancer volume 13, pages 273–282 (2013)Cite this article

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Abstract

Malignant ascites presents a considerable clinical challenge to the management of ovarian cancer, but also provides a wealth of opportunities for translational research. The accessibility of ascitic fluid and its cellular components make it an excellent source of tumour tissue for the investigation of prognostic and predictive biomarkers, pharmacodynamic markers and for molecular profiling analysis. In this Opinion article, we discuss recent advances in our understanding of its pathophysiology, the development of new methods to characterize its molecular features and how these findings can be used to improve the treatment of malignant ascites, particularly in the context of ovarian cancer.

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Figure 1: The peritoneum, peritoneal membrane and ascites.

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Acknowledgements

The Drug Development Unit, the Institute of Cancer Research and the Royal Marsden Hospital NHS Foundation Trust acknowledge support from Cancer Research UK, through core support and an Experimental Cancer Medicine Centre grant and from the National Institute of Health Research, as a Biomedical Research Centre. E.K. acknowledges support from the Wellcome Trust as a clinical research fellow.

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Authors and Affiliations

  1. Emma Kipps is at The Institute of Cancer Research/Royal Marsden Hospital, Medicine, Downs Road, Sutton SM2 5PT, UK.,

    Emma Kipps

  2. David S. P. Tan is at The Drug Development Program, Princess Margaret Hospital, 610 University Avenue, Toronto M5G 2M9, Canada.,

    David S. P. Tan

  3. Stan B. Kaye is at The Drug Development Unit, Sycamore House, Royal Marsden NHS Foundation Trust, Downs Road, Sutton SM2 5PT, UK.,

    Stan B. Kaye

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Glossary

Omentum

A fold of peritoneum connecting or supporting abdominal structures, such as the stomach and liver.

Paracentesis

The procedure to remove fluid that has accumulated in the abdominal cavity (peritoneal fluid) by inserting a wide-bore needle through the abdominal wall.

Satiety

A condition of being full beyond capacity.

Starling's hypothesis of capillary haemodynamics

The direction and rate of fluid transfer between blood plasma in the capillary and fluid in the tissue spaces depend on the hydrostatic pressure on each side of the capillary wall, on the osmotic pressure of protein in plasma and in tissue fluid, and on the properties of the capillary walls as a filtering membrane.

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Kipps, E., Tan, D. & Kaye, S. Meeting the challenge of ascites in ovarian cancer: new avenues for therapy and research. Nat Rev Cancer 13, 273–282 (2013). https://doi.org/10.1038/nrc3432

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