Background:The gut microbiota (GM) plays a critical role in colorectal cancer (CRC) immunotherapy and has attracted considerable scholarly attention in recent years. However, no bibliometric analyses on this topic have been reported to date. To elucidate the current research landscape and guide future studies, we conducted a comprehensive and multidimensional bibliometric analysis of literature from 2014 to 2024. Methods:Publications on GM and CRC immunotherapy spanning 2014-2024 were retrieved from the Web of Science (WoS) core collection and analyzed and visualized using CiteSpace, VOSviewer, and Scimago Graphica. Results:Over the past decade, the WoS core collection (WoSCC) has indexed 325 publications related to GM and CRC immunotherapy, involving 45 countries and regions, 604 institutions, and 2,206 authors. Within the top 20 most productive countries/regions, China accounts for 47% of the total output, significantly surpassing all other nations. The most prolific institution is Shanghai Jiao Tong University (N=14,471 citations; 33.64 citations per article). Among the top ten authors in terms of productivity, seven are based in China. Frontiers in Immunology has the highest publication count in this field (21 articles, accounting for 6.5%). Analysis of the most-cited literature, citation bursts, and keywords highlights a strong association between the GM and the efficacy of immunotherapy for CRC. Certain bacterial species, such as Fusobacterium nucleatum (F. nucleatum), have emerged as promising diagnostic biomarkers and therapeutic targets. Immune checkpoint inhibitors (ICIs), including nivolumab, exhibit marked efficacy in specific molecular subtypes of CRC. Additionally, microbiota-targeted interventions, such as probiotics, have been shown to enhance the therapeutic outcomes of both chemotherapy and immunotherapy. Current research is primarily focused on elucidating microbiota-immune interaction mechanisms and advancing their clinical translation. The updated 2025 literature suggests a shift from descriptive microbiome profiling toward translational applications, including microbiota modulation, engineered microbial platforms, metabolite-based mechanisms, and nanomedicine strategies. However, current evidence remains dominated by reviews and preclinical studies, with limited clinical validation. Conclusions:The relationship between GM and immunotherapy for CRC remains in the exploratory and validation stages, with a mature framework for clinical translation yet to be established. This bibliometric analysis maps the current research landscape, identifies emerging hotspots, and suggests that the field is moving toward translational application. However, unresolved causality, limited biomarker reproducibility, insufficient methodological standardization, and the lack of well-designed CRC-specific clinical trials remain major barriers to clinical implementation.
Colonoscopy is the most widely performed endoscopic procedures in the United States and considered as primary screening and surveillance modality for colorectal cancer (CRC) prevention. Effective screening and surveillance requires prompt recognition of colorectal polyps, optical diagnosis of predicted histology and safe and effective polypectomy. We aim to perform a comprehensive review of the current evidence on tools and techniques to improve polyp detection and best practices to optimize endoscopic removal. Utilization of water assisted colonoscopy, artificial intelligence (AI), image enhanced endoscopy (IEE) and distal attachment devices can improve polyp detection. Underwater endoscopic mucosal resection (EMR) has emerged as a popular technique with potentially better outcomes than conventional EMR. Modification of EMR techniques including tip-in EMR and pre-cutting EMR have also been summarized. Endoscopic full thickness resection (EFTR) is an emerging technique other than endoscopic submucosal dissection (ESD) for suitable lesions harboring early submucosal cancer. Further, we also outline the common adverse events associated with polypectomy including bleeding, perforation, post-polypectomy syndrome, and discuss preventative measures to mitigate these adverse events. Eventually, the goal of colonoscopy is to reduce interval CRC incidence and mortality, and the technology that reduces post colonoscopy CRC incidence and techniques that improve safety and recurrence would see earlier adoption in the real world practice.
