Two decades of progress in gastric cancer peritoneal metastasis: a bibliometric perspective on molecular mechanisms and therapeutic innovations

Abstract

Background: Gastric cancer (GC) is the fifth most common malignant tumor worldwide. The peritoneum is a common site of metastasis in advanced GC, and patients with gastric cancer peritoneal metastasis (GCPM) have a very low 5-year survival rate. Systemic therapy has limited efficacy for peritoneal metastases, and early diagnosis is difficult. In this paper, we analyzed the GCPM-related literature by bibliometric methods, aiming to identify the research hotspots and trends and to provide a basis for clinical practice and research planning.

Methods: Based on the Web of Science Core Collection database (WoSCC), we screened the GCPM-related literature published from 2004 to 2024. Countries, institutions, authors, journals, and keywords were analyzed and visualized by tools such as CiteSpace, VOSviewer, Scimago Graphica, RStudio, and the Bibliometrix package.

Result: A total of 2416 publications were included in this study. The growth rate of GCPM publications is positive until 2021, with a slowdown in the near future. Japan dominated the research output (842 publications), followed by China (748 publications) and the United States (268 publications). Japanese-affiliated organizations and researchers are extremely productive in the field of GCPM. The most frequently cited document was Japanese gastric cancer treatment guidelines 2014 (ver. 4) (citations = 2076). Research focuses on four major clusters: (1) molecular mechanisms of GCPM; (2) prognosis of GCPM; (3) chemotherapy of GCPM; and (4) intraperitoneal treatment of GCPM. Emerging trends include key pathways of GCPM, artificial intelligence (AI) and multi-omics-driven early diagnosis, novel intraperitoneal therapeutic modalities, and immunologic/targeted drugs.

Conclusion: Japan is a leader in GCPM research. Recently, the focus of GCPM research has shifted from basic treatment to precision and personalized treatment through the integration of molecular mechanisms, novel intraperitoneal therapeutic modalities, and AI technologies. Current challenges include the lack of standardized validation systems for emerging technologies and regional differences in clinical practice. In the future, there is a need to promote global collaborative trials and optimization of multimodality therapy. The results of this study provide a key direction and systematic basis for future exploration of GCPM.

Keywords: bibliometric; gastric cancer; intraperitoneal treatment; molecular mechanisms; peritoneal metastasis.

Figure 1

Literature search strategy for GCPM fields based on PRISMA 2020 guidelines. “Identification” shows the screening field, “Screening” shows the screening criteria, and “Included” shows the final included literature.

Figure 2

Trend chart of annual publications and literature citations in the GCPM field from 2004 to 2024. The bar graph represents the annual number of publications (left Y-axis), and the line graph shows the cumulative number of citations (right Y-axis).

Figure 3

Geographic map of the top 20 countries with publications in the GCPM field. Node size corresponds to publication volume; colors and connecting lines indicate national cooperation networks.

Figure 4

Top 20 corresponding authors’ countries. SCP (Single Country Publication, a publication in which all authors are from the same country); MCP (Multiple Country Publications, which refers to publications co-authored by authors from two or more countries).

Figure 5

(A) Visualization of the cooperation network between the top 20 countries with publications in the field of GCPM. (B) Overlay visualization maps based on time changes. The node size indicates the number of publications, the color indicates the cluster to which the country belongs, and the thickness of the line indicates the level of cooperation between countries.

Figure 6

The main collaboration network of institutions. The size of the nodes represents the number of publications, and the color gradient indicates the year of publication (from dark for 2004 to light for 2024). From: CiteSpace.

Figure 7

The collaboration network of core authors. The size of the nodes represents the number of publications, and the color gradient indicates the year of publication (from dark for 2004 to light for 2024). From: CiteSpace.

Figure 8

Three-field plot (middle field: authors; left field: countries; right field: institutions). The thickness of the links is positively correlated with the number of scholarly outputs.

Figure 9

Visualization of journal analysis. (A) The top 10 journals by publication volume. (B) The growth trend of journal publications.

Figure 10

The dual-map overlay of journals related to GCPM. The left area represents citing journals, and the right area represents cited journals; the color of the lines indicates different disciplines.

Figure 11

Visualization map of co-cited references. Node size indicates the frequency of occurrence of the cited literature, and lines between nodes indicate the presence of co-occurrence.

Figure 12

Keyword co-occurrence networks in the GCPM field. Node size indicates the frequency of keyword occurrence; lines between nodes indicate the presence of co-occurrence relationships; and the keyword co-occurrence network is divided into four color-coded clusters based on the evolution of research hotspots.

Figure 13

Keywords heat map. The graph shows how the frequency of keyword occurrences varies according to time. The color gradient goes from blue (low frequency) to red (high frequency).

Figure 14

Top 20 keywords with the strongest citation bursts. The bar chart highlights keywords that have experienced significant surges in citations over specific time .s. The length and color of the bars indicate the duration and intensity of the citation bursts, respectively.

Figure 15

A timeline and keyword clustering display for the GCPM. This timeline graphically illustrates the evolution of research hotspots in the field of GCPM, with cluster sizes indicating the frequency of keyword occurrences and connecting lines indicating changes in research trends over time. From: CiteSpace.