A model of tumor cell progression in the ascites of ovarian cancer patients post-chemotherapy.

<p>Most ovarian cancer patients at diagnosis (stage IIIc/IV) present with ascites (CN) which consists of fibroblast-like stromal cells and a very few tumor cells. The majority of these patients (∼80%) after surgery and first line of chemotherapy return with recurrent cancer associated with ascites (CR). During the course of chemotherapy treatment and subsequent relapses, the percentage of stromal cells in the ascites is gradually decreased and the patient with recurrent cancer presents with ascites that consists mostly of CA125⁺⁺⁺/EpCAM⁺⁺⁺/STAT3⁺⁺⁺chemoresistant epithelial NAD tumor cells. These CA125⁺⁺⁺/EpCAM⁺⁺⁺/STAT3⁺⁺⁺ rich tumor cells are the eventual source of extraovarian peritoneal adhesions. These adhesions are the ultimate cause of patient mortality.