MODERN VIEW ON ASCITE IN OVARIAN CANCER

Malignant ascites is often found in ovarian cancer, moreover, about 10% of patients suffer from recurrent ovarian cancer. More than a third of patients with ovarian cancer have ascites while diagnosed, and almost all has ascites when it relapses. The presence of ascites correlates with the peritoneal spread of ovarian cancer and is associated with a poor prognosis of the disease. Malignant ascites acts as a reservoir of a complex mixture of soluble factors and cellular components that provide a tumor-stimulating microenvironment for tumor cells. Tumor cells in OV associated malignant ascites contribute to the recurrence of the disease, and the mortality of patients is mainly associated with dissemination and metastasis with concomitant effusions in the abdominal cavity. Malignant cells derived from ascites are a major source of morbidity and mortality for patients with ovarian cancer. Subpopulations of these tumor cells have increased resistance to therapy and the ability to distant metastasis and relapse. The anti-angiogenic targeted agent bevacizumab and pazopanib also showed good effects in the symptomatic treatment of malignant ascites of the ovarian cancer, significantly prolonging the time until the next paracentesis.

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