The 50 most cited articles on long bone metastatic disease: A bibliometric analyses.

Abstract

This bibliometric analysis seeks to provide a thorough examination of the research landscape pertaining to long bone metastatic disease. Given the rising prevalence of skeletal metastases, it is imperative to evaluate existing research to guide future research endevours. In August 2025, a comprehensive literature search was conducted using Publish or Perish software to access Google Scholar, focusing on the keyword "long bone metastatic disease." A total of the 50 highest cited articles were identified based on defined inclusion criteria. Citation metrics, study designs, and geographic distribution were analyzed, and keyword co-occurrence analysis was employed to find primary thematic areas. The findings show an increase in publication activity starting in the early 2000s, paralleling advancements in oncological treatments that have improved survival outcomes. Among the top articles, 64 % utilized retrospective cohort designs, and no randomized controlled trials (RCTs) were found. The geographical analysis revealed a significant concentration of publications from North America and Western Europe, which comprised over 70 % of the literature, whilst contributions from low- and middle-income countries were notably sparse. The keyword co-occurrence analysis highlighted three predominant thematic clusters: surgical management, prognostic considerations, and outcomes/complications.Discussion:This analysis underscores the prevalent focus on surgical management strategies, particularly regarding the treatment and prevention of pathological fractures in patients with long bone metastases. However, the lack of high-level evidence combined with limited representation from diverse populations signals crucial gaps that must be addressed in future research endeavors. This bibliometric review offers a comprehensive overview of the influential literature surrounding long bone metastatic disease, revealing significant trends and identifying critical shortcomings. Future investigations should concentrate on generating high-level evidence while enhancing inclusivity in research populations, thus ensuring management strategies are effective and aligned with the holistic needs of patients enduring this complex condition.