Abstract
Epithelial ovarian cancer is the leading cause of death from gynecologic malignancy among women in developed countries. Epithelial ovarian cancer has a poor prognosis, due to the aggressive characteristics of the disease combined with the lack of effective therapies. Options for late-stage ovarian cancer are limited and invasive, especially once malignant ascites develops. Malignant ascites, a complication observed in terminal ovarian cancer, significantly contributes to poor quality of life and to mortality. Excess accumulation of fluid in the peritoneal cavity occurs due to a combination of impaired fluid drainage and increased net filtration, mostly due to increasing intraperitoneal vascular permeability. Here we applied non-invasive magnetic resonance imaging (MRI) and spectroscopic imaging (MRSI) of syngeneic mouse tumors in vivo, and high-resolution 1H MRS of mouse tumor extracts, to characterize the relationship between ascites volumes and the vasculature and metabolism of an experimental model of ovarian cancer. Differences were observed in the tumor vasculature and metabolism in tumors based on ascites volumes that provide new insights into the development of this condition.
Highlights
Epithelial ovarian cancer is the leading cause of death from gynecologic malignancy among women in developed countries with an estimated incidence of 205,000 cases worldwide per year resulting in ∼125,000 deaths [1]
Malignant ascites is a complication observed in terminal ovarian cancer that significantly contributes to poor quality of life and to mortality
Local secretion of vascular endothelial growth factor (VEGF) is a key factor in both tumor growth and ascites formation [5]. 38% of malignant ascites occurring in women are associated with ovarian cancer
Summary
Epithelial ovarian cancer is the leading cause of death from gynecologic malignancy among women in developed countries with an estimated incidence of 205,000 cases worldwide per year resulting in ∼125,000 deaths [1]. Malignant ascites formation is thought to occur due to increasing intraperitoneal vascular permeability [4]. 38% of malignant ascites occurring in women are associated with ovarian cancer. During the course of the disease, more than one-third of women with ovarian cancer will develop ascites [3]. Free-floating cancer cells that are shed from the primary tumor are often present in ascitic fluid, leading to intraperitoneal metastases [4]. A majority of women diagnosed with epithelial ovarian cancer have intra-abdominal metastasis at the time of diagnosis. The identification of mechanisms involved in the aggressiveness of ovarian cancers and its associated pathologies, including formation of metastases and build-up of ascitic fluid, is urgently needed to provide new targets for more effective control and treatment
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