Molecular mechanism of peritoneal dissemination in gastric cancer

Abstract

Peritoneal dissemination (PD) is the most common cause of metastasis in gastric cancer (GC). Because there are no standard treatments for PD, it is associated with a poor prognosis. Although clinicians have performed intraperitoneal chemotherapy for GC with PD, the outcome remains unsatisfactory. Therefore, the development of novel treatments and diagnostic tools for PD is expected to improve the prognosis of GC patients with PD. Notably, it is essential to elucidate the molecular mechanisms involved in the development of PD in GC. In this review, the molecular mechanisms of PD (three steps: detachment from the primary tumor, adaptation to the microenvironment of the peritoneal cavity, and attachment to peritoneal mesothelial cells) and new topics in GC are highlighted.

Conversion Surgery with HIPEC for Peritoneal Oli-gometastatic Gastric Cancer

“…The problem of synchronous peritoneal metastases (PM) in gastric cancer (GC) affects about 5% to 30% of patients, whereas the incidence of peritoneal relapse is 46% to 54% [1,2]. Many metastasis-related factors, such as adhesion molecules, matrix proteases, and motility factors, are involved in a multistep process of the peritoneal dissemination [3]. The 5-year survival rate in the entire population of patients with GC is 15% to 20%; however, it decreases drastically with the stage of the disease.…”

Dysregulation of miRNAs as a signature for diagnosis and prognosis of gastric cancer and their involvement in the mechanism underlying gastric carcinogenesis and progression

“…The widespread curative treatment for GC is D2 surgical resection blended with chemotherapy. Although surgery, chemotherapy, and other treatment plans continually develop in the management of GC patients, their prognosis remains poor . The high mortality rate related to GC is mainly attributed to the lack of informative tumor markers for early detection as well as an effective medical treatment for patients in advanced stages of the disease.…”

“…Although surgery, chemotherapy, and other treatment plans continually develop in the management of GC patients, their prognosis remains poor. [7][8][9] The high mortality rate related to GC is mainly attributed to the lack of informative tumor markers for early detection as well as an effective medical treatment for patients in advanced stages of the disease. In fact, early detection is beneficial and essential for successful surgical removal of GCs, due to the fact that peritoneal dissemination and local and distal metastasis often appear in the late stages of GC and noticeably reduce the efficacy of surgery.…”

Development and Biological Analysis of a Novel Orthotopic Peritoneal Dissemination Mouse Model Generated Using a Pancreatic Ductal Adenocarcinoma Cell Line

“…The development of PD involves a multistep process that includes cell shedding and transport, survival in the microenvironment of the peritoneal cavity, adhesion to the mesothelial layer, invasion of and proliferation into the submesothelial stroma, and potential access to systemic circulation. 7 , 8 In addition to this passive dissemination, evidence has accumulated pointing to the existence of the following 2 pathways of the PD process of gastroenteropancreatic and ovarian cancers: a lymphatic pathway via milky spots in the omentum and transport via the vascular network. 9 – 12 However, the mechanisms underlying this propensity for metastasis remain poorly understood.…”