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BackgroundThe contribution of hepatitis B virus (HBV) and hepatitis C virus (HCV) to primary liver cancer (PLC) and their association with cancer aggressiveness remains uncertain in China, a country with half of global PLC. We aimed to characterize this using data from four representative medical centers.MethodsIn total, 15,801 PLC patients were enrolled from the centers distributed in Easter5n, Southern, Northern, and Western China from 2003 to 2020. Of those, 7585 with curative surgery were involved in survival analysis. A nomogram was constructed using preoperative parameters to predict postoperative survival.ResultsHepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma, and combined hepatocellular cholangiocarcinoma accounted for 93.0%, 4.3%, and 1.6% in PLC, respectively. The seropositivities of HBV and HCV were 84.4% and 3.2% in HCC, respectively. The seropositivity of anti-HCV antibody was significantly higher in HBV-negative than in HBV-positive HCC patients (13.2% vs. 1.1%). Compared to HCV-positive HCC (HCV-HCC), HBV-positive HCC (HBV-HCC) was associated with 12-year earlier onset, higher proportions of males, high α-fetoprotein, large tumor size, advanced Barcelona Clinic Liver Cancer (BCLC) stage, and vascular tumor thrombus. The proportions of HCC and HBV seropositivity increased, whereas that of anti-HCV decreased, from 2003 to 2020. Postoperative five-year survival rate was 73.5%, 64.1%, 34.9%, and 19.7% in HCC at BCLC stage 0, A, B, and C, respectively. The multivariate Cox regression analysis showed that HBV seropositivity, incomplete tumor capsule, vascular tumor thrombus, tumor diameter (≥3 cm), advanced BCLC stage (B+C), α-fetoprotein (≥20ng/ml), and direct bilirubin (>8µmol/L) contributed independently to shorter overall survival (OS); whereas post-operative radiofrequency ablation and second resection independently improved OS in HCC. HCV-HCC had a more favorable prognosis than did HBV-HCC (Log-rank test, P

ObjectiveTo determine the characteristics and spatiotemporal distribution of major gastrointestinal (GI) neoplasms in inpatients from 1995 to 2016 in Wuwei city, northwestern China.MethodData from all paper and electronic medical records entered between 1995 and 2016 at 12 major public hospitals in Wuwei city were retrospectively collected. Patients with GI neoplasms were identified and classified according to the International Classification of Diseases (ICD)-10. Trends in the incidence of major GI neoplasms were expressed as an annual percentage change (APC), and the Z test was used to assess the time fluctuation trends. Age-standardized incidence rates (ASIRs) were also calculated and the corresponding APC was estimated by the Joinpoint software for long-term trend analysis. Thematic maps of annual incidence at the township level were produced.ResultsAmong the 19,137 new inpatients identified with GI neoplasms in Wuwei, gastric cancer was the leading cause of morbidity, followed by cancers of the esophagus, colorectum, gastric cardia, liver, and pancreas with ASIRs of 21.8, 11.0, 5.8, 5.7, 4.4, and 1.7 per 100,000 person-years, respectively. Overall, there was a steady increase in the ASIR for all GI neoplasms, and male cases were 2.1 times more frequent than female cases. The ASIR significantly increased by 12.2% per year from 1995 to 2009 for all GI neoplasms, and the increase rates ranged 9.4%-16.7% per year for the individual GI neoplasm. Despite an increase by 1.4% per year from 2009 to 2016, the ASIR decreased for esophageal and gastric cardia cancers by 4.6% and 17.3% per year, respectively. The annual incidence of all GI neoplasms showed significantly differential geographic distributions among different townships of the city during the study period.