Ovarian cancer is often found at stages 3 or 4, with a high mortality rate of about 80%. Approximately 70% of ovarian cancer patients have cancer cells that have spread to the peritoneum, indicating a very rapid rate of metastasis. Research has revealed that behind the dangerous characteristics of these cancer cells lies a cunning strategy that remodels the peritoneum and other abdominal structures to favor itself.
The research team from the University of Basel, Switzerland, announced that they discovered how ovarian cancer reshapes the intra-abdominal environment to be cancer-friendly through a paper published in the international journal 《Nature Communications》 in January 2026. The team successfully created a cellular map by precisely analyzing 36 tissue samples from the omentum (greater omentum) of 15 patients.
The omentum of the peritoneum is a fatty tissue that protects organs and performs immune functions, but when cancer cells invade, immune cells turn into accomplices that aid in cancer spread. In particular, specific immune cells that weaken the ability to attack tumor cells increase significantly, and regenerative cells are reprogrammed (remodeled) to assist in cancer metastasis.
According to the research findings, ovarian cancer cells change the cellular composition of the entire organ the moment they reach the omentum. This means that changes begin at the cellular level even in distant areas that are not visible. The research team identified a 'pre-metastatic niche' in the small omentum area, which is often left behind during surgery. This refers to a 'specific microenvironment that aids metastasis' created by factors secreted by the primary tumor before cancer cells spread.
In this area, there was a dense network of DNA traps created by white blood cells, known as 'neutrophil extracellular traps.' This mesh, created by immune cells to capture bacteria, falls prey to the cunning strategy of ovarian cancer, serving as the most suitable landing pad for cancer cells. The sentinel white blood cells are deceived by cancer signals, effectively creating a parking lot exclusively for cancer cells.
The research team stated that ovarian cancer cells have already infiltrated even very distant tissues that are not yet visible, effectively taking control of the entire organ and paralyzing its original healthy structure and regenerative capabilities. This research result (Ovarian cancer metastasis to the human omentum disrupts organ homeostasis and induces fundamental tissue reprogramming) was recently published in the international journal 《Nature Communications》.
Ovarian cancer shows a very high fatality rate. According to data from the Central Cancer Registry (2024), if cancer is found in a state where it has already spread throughout the peritoneum (stage 3 or higher), the 5-year survival rate drops sharply to 30-40%. Additionally, there were 3,263 cases of ovarian cancer reported in the country in 2022, accounting for about 2.4% of all female cancers. By age group, those in their 50s accounted for about 28%, followed by those in their 60s and 40s. The mortality rate for ovarian cancer in the country has been steadily increasing, which is analyzed to be closely related to the unique cunning metastasis mechanism of ovarian cancer cells.
One of the main risk factors for ovarian cancer is the frequency of ovulation. Early menarche, late menopause, and infertility increase the risk of developing ovarian cancer as the number of ovulations increases. Generally, the presence of specific genetic mutations (BRCA1 or BRCA2) significantly increases the incidence rate. Initial symptoms often present as common symptoms such as indigestion, abdominal bloating, and pelvic pain. Because of this, many patients misinterpret ovarian cancer symptoms as simple gastrointestinal diseases and miss the opportunity for treatment.
Once cancer cells begin to remodel the peritoneum and other abdominal cavities, the speed at which they spread becomes uncontrollable. This is why it is essential to have regular gynecological check-ups and pay special attention to unusual symptoms. Modern medicine is also fiercely countering the rapid metastasis of cancer cells. Scientists are researching strategies to artificially dissolve the sticky nets created by white blood cells or block the formation of these nets using drugs in combination with existing chemotherapy agents.
A typical method involves administering specific enzymes (DNase I) that break down the nets as if cutting them with scissors or inhibiting essential enzymes (PAD4) for net formation to completely block the creation of traps. There is also ongoing development of 'precision strike technology' that delivers therapeutic agents in nanoparticle form, focusing on areas expected to undergo remodeling by cancer cells. With the completion of the cellular map by the University of Basel, it is expected that the paradigm of ovarian cancer treatment will change, shifting from cancer cell removal to normalizing the altered environment.
[Frequently Asked Questions]
Q1. Why is ovarian cancer metastasis particularly rapid within the abdominal cavity?
A1. Ovarian cancer cells do not simply move; they form a 'pre-metastatic niche' that alters the environment of the omentum or peritoneum to their advantage. In particular, it has been revealed that white blood cells, upon receiving signals from cancer cells, create a 'sticky net' that facilitates an easy landing environment for cancer cells, which is the key reason for the rapid metastasis.
Q2. Why is the small omentum area mentioned in this study important?
A2. The small omentum is a small fatty tissue located between the stomach and liver, and during previous ovarian cancer surgeries, it was often not removed if cancer cells were not visible. However, this study revealed that the small omentum area is utilized as an early base for cancer cell metastasis. Therefore, in the future, broader resection surgeries that include the small omentum area may be considered for preventing recurrence.
Q3. When can we expect treatments that exploit the metastasis strategies of ovarian cancer to be commercialized?
A3. Research is actively being conducted on using specific enzymes (DNase I) that dissolve white blood cell nets or inhibitors (PAD4 inhibitors) that prevent net formation in combination with existing chemotherapy agents. Some have entered clinical trial stages, and with the completion of the cellular map, more precise strikes have become possible. New combination therapies that block cancer metastasis are expected to emerge within a few years.
