The pathogenesis of ascites in ovarian cancer is complex and multifactorial, but it is generally agreed that ascitic fluid build-up occurs if fluid production is heightened, which is facilitated by increased capillary permeability (largely driven by the upregulation of vascular endothelial growth factor (VEGF)), or if the lymphatic drainage capacity of the abdomen is compromised owing to the obstruction of lymphatic stomata in the peritoneum by tumour cells1,2,16,17(Fig. 2). This evidence concerns the gene VEGFA and ovarian cancer.