Peritumoral adipose tissue: A bidirectional regulator of cancer

The tumor-associated microenvironment, shaped by dynamic crosstalk between tumor cells and peritumoral adipose tissue (PAT), has attracted growing attention in recent years. Beyond serving as a passive energy reservoir, PAT actively contributes to tumor progression through metabolic reprogramming, modulation of immune cell function, and remodeling of the stromal vascular fraction. Conversely, tumors induce profound structural and functional reorganization in PAT, including fibrosis, browning, and systemic effects such as cachexia, which further enhances tumor progression. Together, these changes reinforce a tumor-supportive microenvironment. Collectively, these reciprocal interactions underscore the pivotal role of adipose tissue in shaping tumor behavior. This review provides a comprehensive overview of the multifaceted roles of PAT in tumor development, elucidates the mechanisms underlying the bidirectional tumor-adipose interaction, and discusses emerging therapeutic strategies targeting the adipose-tumor axis as a promising avenue for cancer treatment.