Abstract

Simple SummaryOvarian cancer has a poor prognosis and tends to develop peritoneal dissemination. It is becoming increasingly clear that mesothelial cells that cover the peritoneal cavity are involved in ovarian cancer progression. Mesothelial cells are numerous in the peritoneal cavity and normally play many functions to maintain the peritoneal environment. In the tumor microenvironment, mesothelial cells that gain mesenchymal features and cooperate with ovarian cancer are called ovarian cancer-associated mesothelial cells, and they must help ovarian cancer cells to adhere to the peritoneum, invade, and disseminate. Elucidating and targeting these processes may improve the prognosis of ovarian cancer, which is difficult to cure.Ovarian cancer has one of the poorest prognoses among carcinomas. Advanced ovarian cancer often develops ascites and peritoneal dissemination, which is one of the poor prognostic factors. From the perspective of the “seed and soil” hypothesis, the intra-abdominal environment is like the soil for the growth of ovarian cancer (OvCa) and mesothelial cells (MCs) line the top layer of this soil. In recent years, various functions of MCs have been reported, including supporting cancer in the OvCa microenvironment. We refer to OvCa-associated MCs (OCAMs) as MCs that are stimulated by OvCa and contribute to its progression. OCAMs promote OvCa cell adhesion to the peritoneum, invasion, and metastasis. Elucidation of these functions may lead to the identification of novel therapeutic targets that can delay OvCa progression, which is difficult to cure.

Highlights

  • Ovarian cancer (OvCa) is the primary cause of death among patients with malignant gynecologic neoplasms

  • The ability to infiltrate the peritoneum varies according to the histological subtype, individual case, and cell lines, we mainly focused on reports related to high-grade serous carcinoma in this review

  • Based on Dr Stephen Paget’s theory, seeds of ovarian cancer (OvCa) cells cultivate the soil of mesothelial cells (MCs) for OvCa-associated MCs (OCAMs) of the peritoneum by nourishing them with TGF-β1, which promotes the progression of peritoneal dissemination

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Summary

Introduction

Ovarian cancer (OvCa) is the primary cause of death among patients with malignant gynecologic neoplasms. Half of all patients develop recurrent tumors—usually in the peritoneum—even after primary tumor excision [5,6]. Based on these features, controlling peritoneal dissemination is the key to improving the prognosis of OvCa. According to the “seed and soil” hypothesis [7,8], the peritoneum offers a highly compatible microenvironment for metastatic OvCa cells [9]. The peritoneal surface is covered by a monolayer of mesothelial cells (MCs) [12], which are thought to play a major role in OvCa-induced peritoneal environment alteration. We highlight the special function of OCAMs in each phase of metastasis in terms of direct and indirect cell-to-cell crosstalk with OvCa cells

Characteristics and Role of MCs and the Association with OvCa
Biological Process of Peritoneal Dissemination of OvCa
OCAMs and OvCa Adhesion
OCAMs Represent One of the Stromal Components Promoting Tumor
Findings
Future Prospects
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