Metastatic organotropism in peritoneal metastasis: Paget's hypothesis revisited
Kim D., Kaushal D., Wilson RB.
Narrative Review, published in Clin Exp Med (2026) — summary generated from the PubMed abstract.
Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.
- Level A · Stronger Clinical Evidence
- Level B · Emerging clinical evidence with positive signals
- Level C · Early human research exploring benefits
- Level D · Scientific groundwork from lab and animal studies
- Emerging · Emerging topic under active research
This page is generated from the PubMed record. The Thai description is an automated summary of bibliographic fields and the abstract, not a full translation, and is not medical advice.
- Study type
- Narrative Review
- Journal
- Clin Exp Med (2026)
- Reported sample size
- —
- Source database
- Europe PMC
- PMID
- 41609906
- PMCID
- PMC12858513
- DOI
- 10.1007/s10238-025-01868-9
- Citations
- 1
Abstract (original English)
Peritoneal metastasis (PM) of solid tumours is a major contributor to cancer-associated mortality and morbidity. The mechanism of PM development encapsulates Paget's hypothesis of seed and soil, whereby cancer cells remotely prepare a pre-metastatic niche in the peritoneal microenvironment to facilitate transcoelomic cancer progression. The bidirectional communication between cancer cells and host mesothelial cells, endothelial cells, leukocytes, adipocytes, and fibroblasts occurs via exosomes. Exosomes are nano-sized extracellular vesicles that carry cargos of proteins, cytokines, and microRNA. Cancer-derived exosomes enable exfoliated tumour cells to resist anoikis, disseminate, adhere, and implant in the peritoneum. This process involves the degradation of the peritoneal glycocalyx, the transformation of peritoneal mesothelial cells into cancer-associated fibroblasts via mesothelial-mesenchymal transition, and metabolic coupling with omental and subperitoneal adipocytes. Exosomes also enhance ascites and peritoneal immunosuppression. Exosomes promote PM development from mesenchymal subtypes of epithelial cancers, which have a predilection for transcoelomic metastasis compared to other molecular subtypes. Mesenchymal subtypes include diffuse gastric cancer, CMS4 colorectal cancer, and high-grade serous ovarian carcinoma. Understanding the oncogenic roles of exosomal cargo off
What this study does not prove
- • This study does not prove SVF is an approved treatment or a replacement for standard care.
- • This is a narrative review: it collects no new patient data and does not systematically appraise evidence quality.
Evidence level
Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.
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