Figure 1.

The three subsequent yet simultaneous phases of ovarian cancer intraabdominal dissemination. Cells disaggregate from the solid tumor (phase 1) and then circulate freely in the peritoneal fluid as spheroids (phase 2). This process allows tumor cells to survive programmed cell death that occurs when cells disconnect from the extracellular matrix. When in contact with the peritoneal surface, the spheroids undergo molecular changes, allowing their adhesion to the mesothelial cells of the peritoneum (phase 3).