4. Discussion
EOC metastasis is unique, as initial dissemination is not primarily
hematogenous yet is facilitated through shedding of primary
tumor cells into the peritoneal fluid and accumulating ascites as the
disease progresses [1,30,31]. Multicellular, compact spheroids are
highly invasive structures that are increasingly accepted as clinically
relevant to EOC metastasis. EOC spheroids are more chemoresistant
relative to single cells. Thus, chemotherapeutic
intervention alone may select for these highly invasive subpopulations.
Combined therapies may offer the greatest impact in
targeting EOC.