Ovarian Cancer Ascites as a Liquid Tumor Microenvironment

Ovarian cancer is a leading cause of death among women in most developed countries. This malignancy is characterized by rapid growth and spread of intraperitoneal tumors, leading to ascites, which is accumulation of fluid in the peritoneum. Despite proof that the accumulation of peritoneal fluid signifies the poorest outcome for cancer patients, the role of malignant ascites in promoting metastasis and therapy resistance remains poorly understood. Malignant ascites presents a unique tumor microenvironment to the tumor cells, non-tumor cells, and various biofactors such as growth factors, cytokines, and lipids. Interest in the characterization of the components of the microenvironment of malignant ascites and their role in the progression of ovarian cancer has increased over the years. In this chapter, we summarize the role of malignant ascites as a liquid tumor microenvironment in the development and progression of ovarian cancer.