From feasibility to clinical pathways: a bibliometric and knowledge-mapping analysis of urine-based liquid biopsy in urologic cancers (2015–2025)

Background Urologic cancers, including prostate cancer, bladder cancer, upper tract urothelial carcinoma and renal cell carcinoma, are well suited to urine-based liquid biopsy because tumors lie close to the urinary tract and often require repeated, minimally invasive monitoring. Over the past decade, multiple urinary analytes and platforms have been explored, but an integrated view of their temporal evolution, global knowledge production and disease-specific application pathways is lacking. Methods Publications on urine-based liquid biopsy in urologic cancers were retrieved from the Web of Science Core Collection (2015–2025); 439 articles and reviews met predefined criteria. CiteSpace, VOSviewer and the bibliometrix R package were used to analyze publication trends, country–institution–author–journal networks, highly cited and burst references, and keyword co-occurrence and evolution. Temporal and thematic patterns were synthesized into a stage-wise framework linking research hotspots with core clinical scenarios. Results Global output increased steadily from 2016, with marked acceleration after 2021. Co-citation and burst analyses supported two phases: an initial “foundational evidence and methodological expansion” phase dominated by circulating tumor DNA and early urine-focused work, and a later “standardization and platform integration” phase characterized by guideline-oriented reviews, liquid biopsy frameworks and consensus documents. The United States and Europe formed the main evidentiary hubs, with East Asian institutions showing rapid recent growth. Keyword analyses revealed two dominant trajectories: diagnostic pathways in prostate cancer, centered on urinary RNA signatures, exosome-based multigene panels and composite risk models in the prostate-specific antigen grey zone; and monitoring pathways in bladder cancer and urothelial carcinoma, focused on urinary DNA methylation and mutation panels and upgraded cytology for recurrence surveillance and cystoscopy de-escalation. Renal cell carcinoma and other less common urologic cancers remained evidence-sparse but clinically important frontiers, with exploratory work on urinary methylation, extracellular vesicles and metabolomics. Conclusions Urine-based liquid biopsy in urologic cancers has progressed from feasibility testing to disease-specific model construction and early standardized implementation. The two-stage pattern and diagnostic/monitoring twin pathways identified here, together with key geographical and methodological gaps, provide a framework for future multicenter cohorts, standardization efforts and clinically oriented trials to embed urinary biomarkers into routine decision-making.