[Translational research advances in peritoneal metastasis of gastrointestinal cancer: from molecular mechanisms to precision therapy].

Peritoneal metastasis is an advanced stage of gastrointestinal cancers. The Transforming growth factor-β (TGF-β), phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR), and Wnt/β-catenin signaling pathways are associated with epithelial-mesenchymal transition, mesothelial-mesenchymal transition, and the formation of an immunosuppressive microenvironment. Moreover, these changes contribute to the development of peritoneal metastasis. Besides, the immune-stromal remodeling also plays an important role in the development of this process. Recent research is increasingly focusing on targeting the PI3K/Akt/mTOR pathway and TGF-β signaling, in combination with immune checkpoint inhibitors. For treatment, cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy and pressurized intraperitoneal aerosol chemotherapy after new local therapeutic options for patients with peritoneal metastasis. This article systematically reviews the advances in basic and clinical-translational research on peritoneal metastasis in gastrointestinal cancers, which gives a reference for shifting the management of peritoneal metastasis from an empirical approach toward a more precise, intervention-based strategy.