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Cross\u2010sectional imaging is limited in sensitivity and specificity, and treating peritoneal metastases is limited by the bioavailability of systemic cytotoxic chemotherapy and metastatic burden. Within this review, we specifically explore the pathophysiology underlying peritoneal metastasis while emphasising the contributions of the tumour microenvironment and immune system.<\/jats:p>","DOI":"10.1002\/jso.70090","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T11:25:18Z","timestamp":1759145118000},"page":"1190-1196","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Peritoneal Metastases in Gastrointestinal Malignancies: A Review of the Pathophysiology of Metastasis and the Tumour Microenvironment"],"prefix":"10.1002","volume":"132","author":[{"given":"Milee","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Surgery Tulane University School of Medicine New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2078-2025","authenticated-orcid":false,"given":"Kristen","family":"Limbach","sequence":"additional","affiliation":[{"name":"Department of Surgery Tulane University School of Medicine New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Medicine Tulane University School of Medicine New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Burow","sequence":"additional","affiliation":[{"name":"Department of Medicine Tulane University School of Medicine New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7455-2308","authenticated-orcid":false,"given":"Kevin M.","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Department of Surgery Louisiana State University Health Sciences Centre New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2014.06.002"},{"key":"e_1_2_10_3_1","volume-title":"StatPearls","author":"Desai J. 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