{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T15:57:49Z","timestamp":1791734269033,"version":"4.3.4"},"reference-count":119,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cDun\u0103rea de Jos\u201d University of Galati, Romania"},{"id":[{"id":"https:\/\/ror.org\/052sta926","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>Gastric cancer peritoneal metastasis is not simply an extension of the primary tumor into the abdominal cavity. It represents a biologically distinct disease context shaped by interactions between disseminated tumor cells, peritoneal fluid, mesothelial surfaces, submesothelial stroma, extracellular matrix, immune populations, and malignant ascites. In this narrative review, we examine peritoneal metastasis as a transition between three related but physiologically different states: the primary gastric tumor, free-floating tumor cells or spheroids in the peritoneal fluid, and established mesothelial or submesothelial metastatic implants. We discuss how tumor cells acquire dissemination competence in the primary tumor, survive detachment and fluid-phase stress, adhere to remodeled mesothelium, recruit stromal and immune support, and adapt to ascites-mediated signaling. We also review how the peritoneal niche may contribute to biomarker discordance, immune exclusion, therapeutic resistance, and limitations of conventional response assessment. Where relevant, we distinguish evidence derived directly from gastric cancer peritoneal metastasis from preclinical data, extrapolation from other peritoneal malignancies, and hypothesis-generating interpretation. Finally, we summarize practical implications for tissue sampling, ascites and lavage analysis, biomarker interpretation, translational modeling, and peritoneal-directed therapeutic strategies. A clearer understanding of the biological divergence between the primary tumor, the fluid-phase compartment, and peritoneal implants may improve the study and clinical management of gastric cancer peritoneal metastasis.<\/jats:p>","DOI":"10.3390\/cells15121055","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T09:46:54Z","timestamp":1780998414000},"page":"1055","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["From Primary Tumor to Peritoneal Niche: Microenvironmental Divergence in Gastric Cancer Peritoneal Metastasis"],"prefix":"10.3390","volume":"15","author":[{"given":"Catalin-Bogdan","family":"Satala","sequence":"first","affiliation":[{"name":"Medical and Pharmaceutical Research Center, Faculty of Medicine and Pharmacy, \u201cDun\u0103rea de Jos\u201d University of Galati, 800008 Galati, Romania"},{"name":"Department of Pathology, Clinical County Emergency Hospital Braila, 810325 Braila, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina-Mihaela","family":"Gurau","sequence":"additional","affiliation":[{"name":"The School for Doctoral Studies in Biomedical Sciences, \u201cDun\u0103rea de Jos\u201d University of Galati, 800008 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Mihalache","sequence":"additional","affiliation":[{"name":"Medical and Pharmaceutical Research Center, Faculty of Medicine and Pharmacy, \u201cDun\u0103rea de Jos\u201d University of Galati, 800008 Galati, Romania"},{"name":"Department of Pathology, Clinical County Emergency Hospital Braila, 810325 Braila, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Patrichi","sequence":"additional","affiliation":[{"name":"The Doctoral School of Medicine and Pharmacy, \u201cGeorge Emil Palade\u201d University of Medicine, Pharmacy, Science and Technology, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana-Cristina","family":"Mehedinti","sequence":"additional","affiliation":[{"name":"Medical and Pharmaceutical Research Center, Faculty of Medicine and Pharmacy, \u201cDun\u0103rea de Jos\u201d University of Galati, 800008 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy Radu","family":"Leibovici","sequence":"additional","affiliation":[{"name":"Medical and Pharmaceutical Research Center, Faculty of Medicine and Pharmacy, \u201cDun\u0103rea de Jos\u201d University of Galati, 800008 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8327-1364","authenticated-orcid":false,"given":"Gabriela","family":"Gur\u0103u","sequence":"additional","affiliation":[{"name":"Medical and Pharmaceutical Research Center, Faculty of Medicine and Pharmacy, \u201cDun\u0103rea de Jos\u201d University of Galati, 800008 Galati, Romania"},{"name":"\u201cSf. Ioan\u201d Clinical Emergency Pediatric Hospital, 800487 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global Cancer Statistics 2022: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Rijken, A., Lurvink, R.J., Luyer, M.D.P., Nieuwenhuijzen, G.A.P., van Erning, F.N., van Sandick, J.W., and de Hingh, I.H.J.T. (2021). The Burden of Peritoneal Metastases from Gastric Cancer: A Systematic Review on the Incidence, Risk Factors and Survival. J. Clin. Med., 10.","DOI":"10.3390\/jcm10214882"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Manzanedo, I., Pereira, F., P\u00e9rez-Viejo, E., and Serrano, \u00c1. (2023). 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