To investigate the hot spots and trends of microvascular invasion (MVI) in predicting clinical prognosis of hepatocellular carcinoma (HCC) worldwide through bibliometric and visual analysis.

Studies related to MVI in predicting clinical prognosis of HCC were obtained from Web of Science core literature database from January 2014 to March 2024. Study types included article and review in English. Statistical and visual analyses of the published articles were performed from the aspects of year, author, institution, country, journal and keywords by using CiteSpace software.

From 2014 to 2024, 1 778 articles were published in the field of HCC-MVI research, showing an overall increasing trend year by year, with a citation frequency of 6 843. These articles were published from 49 countries. The five countries with the highest number of articles were China (1 156), the United States (176), South Korea (157), Japan (119) and Italy (85), mainly from Europe, Asia and North America. The most active country was China and the most active institution was Naval Medical University from China. The most active and cited authors were Lau WY and Bruix J. Chinese institutions conducted less international cooperation, while other countries carried out closer cooperation. The United States had the highest degree of centralization and closer cooperation with other countries. The clustering and timeline map of key nodes in the co-cited network showed that angiogenesis has been the hotspot with the longest duration of research since 2014. Prediction model was the latest keyword with the highest frequency in recent two years. The highlight map of keywords revealed that before 2021, studies mainly focused on biomarkers, liver transplantation and the selection of surgical resection. The recurrence and prognosis after hepatectomy were the hot spots after 2014. In 2015, HCC-related biomarkers and long-term survival rate became the hot spots. The number of predictor-related studies has been significantly increased. Recently, the interests in this field began to shift to radiomics study of HCC and related nomogram calculation. Radiomics and nomogram calculation were the prominent keywords in recent three years, which are currently the important research directions in HCC-MVI field.

CiteSpace-based visualization analysis shows that the research on MVI in predicting clinical prognosis of HCC after surgical resection has been ever advanced in recent decade. Vascular disease has drawn widespread attention. With the advancement of radiomics, the construction of radiomic models captivates extensive attention.