From the Research
Ovarian cancer primarily spreads throughout the abdomen through a process called transcoelomic metastasis, as well as hematogenous and lymphatic routes, with the most recent evidence suggesting a significant role for hematogenous spread in the dissemination of the disease 1. The mechanism of spread involves cancer cells detaching from the primary ovarian tumor and floating freely in the peritoneal fluid that naturally circulates within the abdominal cavity.
- These malignant cells can then implant on various abdominal surfaces including:
- The peritoneum (the membrane lining the abdominal cavity)
- The omentum (fatty tissue covering the intestines)
- The diaphragm
- Surfaces of organs such as the liver, intestines, and bladder This pattern of spread is facilitated by the natural circulation of peritoneal fluid, which follows predictable pathways influenced by gravity and respiratory movements. Additionally, ovarian cancer can spread through:
- Direct extension to adjacent organs
- Lymphatic dissemination to regional lymph nodes
- Hematogenous (blood-borne) metastasis to distant sites like the liver or lungs, though this is less common in early disease, recent studies suggest it may play a larger role than previously thought 1. The ability of ovarian cancer cells to survive in suspension in peritoneal fluid and to adhere to and invade new sites is supported by molecular changes that alter cell adhesion properties and promote survival in this environment, with some studies indicating that proteins like CDCP1 may play a role in this process 2. This transcoelomic spread pattern, along with hematogenous and lymphatic dissemination, explains why ovarian cancer is often diagnosed at advanced stages, as symptoms typically appear only after significant abdominal spread has occurred 3.