A bibliometric study on microenvironment-mediated drug resistance in interventional liver cancer treatment

Microenvironment-driven drug resistance is a principal barrier to durable response after transarterial chemoembolisation, ablation or radioembolisation for hepatocellular carcinoma, yet the global structure of scholarship linking these domains remains undefined. This bibliometric analysis mapped 25-year publication trends, thematic evolution and collaboration networks at the intersection of interventional oncology, tumour microenvironment and therapeutic resistance. Web of Science Core Collection was searched (1 January 2000–31 December 2024) for records simultaneously referencing liver cancer, interventional therapy, microenvironmental descriptors and resistance terms. After dual-review screening, 939 articles and reviews were retained. Annual output, citation impact and Bradford-zone distributions were generated with bibliometrix 4.2.1. Bradford-zone analysis refers to the distribution of journal productivity, with journals in the first zone representing core literature, and those in subsequent zones reflecting peripheral or niche studies. This method helps assess the concentration of research in key journals and identifies areas of growth in the literature; co-authorship, journal-coupling and keyword-co-occurrence networks were rendered in VOSviewer 1.6.20. Workflow reproducibility was confirmed on a 5% subsample and by comparing fractional with full counting. Yearly publications rose from two in 2000 to 130 in 2024, amassing 36 095 citations (mean 38.4 per item). Output spikes in 2013, 2019 and 2021 paralleled seminal reports on hypoxia-driven angiogenesis, CAF activation, and COVID-19-related endothelial dysfunction. The pathophysiological mechanisms of COVID-19-induced endothelial injury, including cytokine-mediated endothelial dysfunction, have been implicated in compromising loco-regional therapies, contributing to resistance mechanisms that affect the efficacy of embolic treatments. China produced 47.3% of documents and sat at the nexus of global collaboration, with prominent links to the United States, Japan and South Korea. Cancer Research, Hepatology and Journal of Hepatology led citation rankings. Keyword overlays revealed a chronological shift from procedure-centric terms to microenvironmental and immunologic nodes—“angiogenesis”, “immune checkpoint”, “nanoparticles”—after 2017. Trend-topic mapping documented a transition from device optimisation toward mechanism-informed combination regimens incorporating anti-VEGF or PD-1 blockade. Research on microenvironment-mediated resistance in interventional liver-cancer therapy has expanded rapidly and pivoted toward molecularly targeted, immune-augmented strategies, driven chiefly by high-volume Chinese centres and trans-Pacific partnerships. Priorities now include single-cell analytics, radiomics-guided adaptive embolisation and multinational trials of combination therapy.