VEGF-A binds to VEGFR1, 2 to facilitate tumour dissemination while VEGF-C, D binds to VEGFR3 to stimulate lymphangiogenesis.42,43 There is a notable difference in expression levels in distant ovarian metastases with one study finding higher expression levels of VEGF-A (p = 0.022), D (p = 0.010) and VEGFR1 (p = 0.046) in distant metastases (omental) as compared to primary high-grade serous ovarian cancer (HGSOC) lesions.42 Another study however showed that VEGF-A values were lower in more advanced disease stages, while CA125 levels showed an upward trend.43 The gene discussed is MUC16; the disease is neoplasm.