Mechanisms of Lymphatic Metastasis and Immune Microenvironment Regulation in Ovarian Cancer: From Molecular Mechanisms to Precision Lympho-Immune Surgery

Abstract

Ovarian cancer is a highly prevalent and lethal malignancy in women, with lymphatic metastasis representing one of the key determinants of patient prognosis. In recent years, advances in molecular biology and immunology have gradually unveiled the multifaceted mechanisms underlying lymphatic dissemination in ovarian cancer, including tumor cell invasiveness, lymphangiogenesis, and the dynamic regulation by immune cells within the tumor microenvironment (TME). The complex interplay among various immune cells not only influences metastatic potential but also provides potential therapeutic targets. Meanwhile, the rise of precision lympho-immune surgery has provided novel strategies for the accurate identification and resection of sentinel or metastasized lymph nodes, offering hope for improved clinical outcomes. This review systematically summarizes the molecular mechanisms of ovarian cancer lymphatic metastasis and its association with the immune microenvironment, with a special focus on advances in precision lympho-immune surgical practice, aiming to provide theoretical and technical support for the development of individualized therapeutic strategies in ovarian cancer.