Adipocytes are dispensable in shaping the ovarian cancer tumor microenvironment in the omentum

The omentum, a specialized adipose tissue within the peritoneum, is a primary niche for ovarian cancer (OC) dissemination during peritoneal carcinomatosis. Traditionally, omental adipocytes are thought to promote OC growth by supplying lipids, supported by evidence that global FABP4 deficiency reduces tumor progression. Here, we generated mice lacking mature adipocytes in the peritoneum, including the omentum. ID8p53-/-Brca2-/-, BPPNM, and KPCA OC cells retained a propensity to seed regions typically associated with adipocytes, even without mature adipocytes. However, the lack of mature adipocytes did not suppress peritoneal OC expansion, whereas removing the adipocyte-free omentum did. Murine and human single-cell RNA sequencing revealed that endothelial FABP4 was high in the omentum. Indeed, endothelial cell-selective deficiency of FABP4 reduced OC growth in the peritoneum. These findings prompt a reevaluation of adipocyte contributions to OC progression and suggest a key role of the omental vasculature in supporting OC metabolic growth.