Decoding colorectal cancer lung metastasis: a global research odyssey

Abstract

Background: Colorectal cancer (CRC) remains a major global health burden, particularly when complicated by pulmonary metastasis (PM), which significantly worsens prognosis and reduces survival despite active treatment. The absence of standardized therapeutic strategies for CRC with PM has driven research into its underlying biological mechanisms, including epithelial-mesenchymal transition, immune evasion, and tumor microenvironment dynamics.

Methods: A bibliometric analysis was conducted on 2,645 publications related to CRC with PM retrieved from the Web of Science Core Collection (1991-2025). Analytical tools such as CiteSpace and VOSviewer were employed to map the intellectual structure, collaboration networks, and research hotspots within this domain.

Results: The analysis identified China and Japan as the most prolific countries in CRC-PM research, with Robert M. Hoffman (USA) and David L. Morris (Australia) as the most productive authors, and Joachim Pfannschmidt (Germany) as the most frequently cited. Annals of Surgery was recognized as the most influential journal. Four primary research themes were identified: (1) molecular mechanisms underlying CRC lung metastasis, (2) surgical intervention strategies, (3) systemic therapies and clinical trials, and (4) clinical management and outcome evaluation. These studies reflect a growing emphasis on multidisciplinary approaches and translational research.

Conclusion: The field has witnessed notable progress in multimodal treatment strategies, encompassing advances in surgical techniques, chemotherapy regimens, and targeted therapies, all of which have contributed to improved patient assessment and survival outcomes. Future research should focus on optimizing integrated therapeutic approaches and refining clinical management protocols to further improve outcomes for patients with CRC and pulmonary metastases.

Keywords: bibliometric analysis; colorectal cancer; molecular mechanisms; pulmonary metastases; surgical treatment.

Figure 1

A comprehensive flowchart illustrating the stages of the publication screening process and the search methodology.

Figure 2

Trends in the annual publication and citation counts for colorectal cancer with pulmonary metastases from 1991 to 2025.

Figure 3

Co-authorship analysis of leading authors in the field of colorectal cancer pulmonary metastases. (A) Overlay visualization highlighting average citation counts. (B) Overlay visualization illustrating temporal trends. (C) Network visualization of collaborative relationships. (D) Dynamic patterns of international scientific collaboration. (E) Geographical distribution and title-term relationships of prominent authors.

Figure 4

Visualization of key academic journals contributing to colorectal cancer lung metastasis research in terms of scope, influence, and publication trends. (A) Overlay dual-map highlighting journals related to colorectal cancer lung metastases. (B) Line chart analysis of the top 5 journals in this field. (C) Citation counts and total publication volumes of the top 22 journals.

Figure 5

Comprehensive bibliometric analysis of key institutions contributing to the field of colorectal cancer pulmonary metastases. (A) Publication trends. (B) Citation trends. (C) Sankey diagram illustrating the relationships among universities, title-terms, and keywords.

Figure 6

Comprehensive visualization of global research productivity, collaboration patterns, temporal trends, and citation impact in colorectal cancer lung metastasis across countries and regions. (A) Network visualization map showing the collaborative relationships among the top 18 most research-active countries/regions. (B) Overlay visualization map illustrating the average publication year across countries/regions. (C) Overlay visualization map highlighting the average publication output per country/region. (D) Geographical distribution of global citations related to colorectal cancer lung metastases. (E) Geographical distribution of global publications in colorectal cancer lung metastases. (F) Bar chart depicting the top 10 most productive countries/regions in the domain.

Figure 7

Density-based visualization of the top 22 most frequently co-cited references.

Figure 8

Keyword co-occurrence analysis revealing thematic clusters. (A) Comprehensive network visualization map. (B) The five most prominent and influential keywords across the four clusters.