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Increasing evidence indicates that the systemic immune-inflammation index (SII) and lactate dehydrogenase (LDH) are correlated with the prognosis of various malignancies. This study aimed to evaluate the prognostic value of pre-treatment SII and LDH in patients with non-metastatic nasopharyngeal carcinoma (NPC). We conducted a retrospective analysis of 756 patients with non-metastatic NPC. The optimal cut-off values for SII and LDH, determined using X-tile software, were 150 and 447, respectively. Independent prognostic factors for survival outcomes were identified using Kaplan-Meier analysis and Cox regression analysis. Patients in the high SII group had significantly worse prognosis in 5-year OS (76.5 vs. 86.7%, p  < 0.001), 5-year DMFS (77.3 vs. 85.4%, p  < 0.001), and 5-year PFS (67.9 vs. 80.5%, p  < 0.001) compared to the low SII group. Patients in the high LDH group had significantly worse prognosis in 5-year OS (72.1 vs. 85.0%, p  < 0.001), 5-year DMFS (72.1 vs. 84.8%, p  < 0.001), and 5-year PFS (63.7 vs. 77.7%, p  < 0.001) compared to the low LDH group.Multivariate analysis showed that high SII and high LDH were significantly associated with poorer OS ( p  = 0.005 vs. p  < 0.001), DMFS( p  = 0.001 vs. p  < 0.001), and PFS ( p  = 0.001 vs. p  < 0.001). These results confirmed that both SII and LDH are independent prognostic factors for OS, DMFS, and PFS. In subgroup analysis, this predictive effect was more pronounced in locally advanced stages. Among patients with locally advanced NPC, the combination of SII and LDH showed the highest AUC values for predicting OS, DMFS, and PFS. Pre-treatment SII and LDH are important prognostic factors in patients with non-metastatic NPC. Furthermore, the combination of both provides a more accurate prognosis for patients with locally advanced NPC than either marker alone.

Larynx cancer poses a significant public health challenge in China, with rising incidence and mortality rates over the past decades. Understanding the long-term trends and underlying factors is crucial for effective intervention and policy formulation. Data were utilized from the global burden of disease (GBD) Study 2021 to analyze the incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) due to larynx cancer in China from 1990 to 2021. Joinpoint regression analysis identified key changes in trends, while age-period-cohort (APC) analysis and decomposition analysis quantified the contributions of aging, epidemiological changes, and population growth to these trends. Our study found a significant increase in the incidence and prevalence of larynx cancer in China, particularly among males. The age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) for males were substantially higher than those for females. Decomposition analysis revealed that aging was the primary driver of increasing incidence and mortality rates, while epidemiological changes had a mitigating effect. Joinpoint analysis identified periods of rapid urbanization and economic growth as key turning points for increased incidence. Bayesian APC models projected a continued upward trend in incidence rates up to 2030. The rising burden of larynx cancer in China underscores the need for targeted public health interventions, including smoking cessation programs, environmental pollution control, and early detection strategies. Addressing gender disparities and implementing effective prevention measures are crucial to mitigating the impact of larynx cancer in China.

Cachexia is a leading cause of death among individuals with advanced cancer, yet effective pharmacological treatments are lacking. In this single-center retrospective study, we aimed to investigate the efficacy and safety of tocilizumab for the treatment of cancer cachexia accompanied by systemic hyperinflammation. Data were collected from 20 patients treated with tocilizumab and a control group of 20 patients matched for age, sex, and comorbidities. Both groups received corticosteroids. In the tocilizumab treatment group, patients received a single dose of tocilizumab (8 mg/kg, maximum 800 mg) in combination with corticosteroids. Weight, body mass index, liver metastasis, Eastern Cooperative Oncology Group score, patient-generated subjective global assessments, the Anorexia/Cachexia Subscale of the Functional Assessment of Anorexia/Cachexia Therapy, handgrip strength, neutrophil-to-lymphocyte ratio, and the C-reactive protein, hemoglobin, prealbumin, and albumin levels were recorded in both groups. Tocilizumab treatment favorably influenced the levels of patient biomarkers (p<0.05), ameliorated systemic inflammation, and demonstrated enhanced clinical short-term efficacy compared to the control group, including rates of symptomatic relief (60% vs. 20%, p = 0.024), improvement of serum PAB and ALB (70% vs. 25%, p = 0.004), weight gain >2% (45% vs. 15%, p = 0.038), and improvement of grip strength and 6-m walk speed (p<0.05). Treatment with tocilizumab was generally safe, with no observed increase in infection rates (10% vs. 15%, p = 0.633) or intensive care unit admissions (10% vs. 25%, p = 0.405), and was more favorable for restarting antitumor therapy (70% vs. 35%, p = 0.027). Tocilizumab, in combination with corticosteroids, is favorable for alleviating cancer cachexia with systemic hyperinflammation, despite the small sample size. Thus, this combination holds great potential as a novel strategy for treating cancer cachexia with systemic hyperinflammation.

Pancreatic cancer is one of the most lethal malignancies globally, with increasing incidence and mortality trends. In China, the disease burden has escalated over the past three decades, yet comprehensive national assessments remain limited. This study aims to evaluate the long-term trends, driving factors, and future projections of pancreatic cancer burden in China from 1990 to 2021. Data on incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) were extracted from the Global Burden of Disease (GBD) Study 2021. Temporal trends were analyzed using Joinpoint regression and age-period-cohort models, while decomposition analysis quantified the contributions of population aging, growth, and epidemiological change. Bayesian age-period-cohort (BAPC) models were applied to project disease burden trends through 2030. In 2021, pancreatic cancer accounted for 118,665 new cases and over 2.9 million DALYs in China, with a significantly higher burden among males. Age-standardized rates of incidence, prevalence, and DALYs increased markedly between 1990 and 2021, outpacing global trends. The burden was concentrated in older age groups and driven primarily by years of life lost. Joinpoint regression identified periods of accelerated increase after 2015. Age-period-cohort analysis revealed that disease burden rises sharply after age 50 and is highest among more recent birth cohorts. Decomposition analysis showed that population aging and epidemiological transitions were the main contributors to increased burden. Projections using BAPC models indicate that incidence, prevalence, and DALY rates will continue to rise through 2030. The burden of pancreatic cancer in China has increased substantially over the past three decades and is projected to rise further. These findings highlight the need for intensified public health interventions focused on prevention, early detection, and effective treatment strategies.

Liver cancer remains a significant public health issue in China, exhibiting high incidence, mortality, and burden. Understanding its temporal trends and projections is essential for designing targeted prevention and treatment strategies. This study analyzes long-term trends in liver cancer incidence, prevalence, mortality, and burden from 1990 to 2021, assessing age, period, and cohort effects, and projecting future trends. Data on liver cancer incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) were analyzed from 1990 to 2021. Joinpoint regression analysis, age-period-cohort (APC) analysis, and BAPC modeling were applied to examine trends and project future trends. Decomposition analysis examined contributions of aging, epidemiological changes, and population growth. The study also compared China’s liver cancer trends with global data. From 1990 to 2021, China experienced a decrease in age-standardized rates for liver cancer incidence, prevalence, mortality, and burden. Notably, Age-standardized incidence rates (ASIR) exhibited a decline after 2016, with a significant reduction in the male population. In 2021, there were 196,637 new cases of liver cancer in China, with a higher burden in males. ASIR were 14.34 per 100,000 for males and 4.89 per 100,000 for females. Mortality also followed a declining trend, with a notable decrease in age-standardized mortality rates. The age-standardized mortality rate (ASMR) for males was 12.4 per 100,000, significantly higher than for females (4.57 per 100,000) in 2021. Additionally, the age-standardized prevalence rate (ASPR) was 20.0 for males and 6.64 for females, with 265,539 total cases. The burden, measured by DALYs, YLDs, and YLLs, also showed a notable decline in age-standardized rates and significant gender disparities. Despite this, the absolute number of cases, deaths, and DALYs has continued to rise due to population growth and aging, with males bearing a significantly higher burden than females. The study also highlights the impact of aging, population growth, and epidemiological changes on liver cancer incidence and mortality in China. Projections for 2030 suggest a continued decrease in liver cancer incidence, especially among females, reflecting the effectiveness of public health interventions and medical advancements. However, gender disparities remain significant, and further efforts are needed to reduce the overall liver cancer burden, with an emphasis on early detection and prevention strategies.

Laryngeal cancer attributable to occupational asbestos exposure remains a significant public health concern, particularly in industrialized regions. This study analyzes the burden, trends, and contributing factors of laryngeal cancer due to asbestos exposure in China from 1990 to 2021. Data were obtained from the Global Burden of Disease Study (1990-2021). We analyzed age-standardized death rates, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs). Temporal trends were assessed using joinpoint and decomposition analyses, and an age-period-cohort (APC) model was applied to examine mortality and DALY trends across different cohorts. In 2021, there were 234 deaths and 4,430 DALYs due to laryngeal cancer attributable to occupational asbestos exposure, predominantly affecting males. Mortality rates declined from 1990 to 2008, followed by a rise until 2012, and a subsequent decline. YLDs showed a consistent increase over time. APC analysis revealed higher mortality and DALY rates in older age groups and earlier birth cohorts. Decomposition analysis indicated that epidemiological changes were the largest driver of increased deaths in men, followed by population growth and aging. For DALYs, aging and population growth were key drivers, while epidemiological changes mitigated the burden. The burden of laryngeal cancer attributable to asbestos exposure has declined overall, but disability rates continue to rise, particularly among males. Effective strategies targeting prevention, early detection, and management of asbestos exposure are needed to reduce the disease burden in China.

Stomach cancer remains a significant public health concern in China, with dietary factors, particularly high sodium intake, being major contributors. This study aimed to quantify the trends, demographic disparities, and contributing factors to this burden from 1990 to 2021. Data from the Global Burden of Disease Study (GBD) 2021 were used to assess the burden of stomach cancer attributable to high sodium intake. The study included age-standardized mortality rates (ASMR), disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs). Joinpoint regression and age-period-cohort (APC) analysis were performed to identify significant trends and changes. Decomposition analysis was used to identify the impacts of aging, epidemiological changes, and population growth. In 2021, stomach cancer attributable to high sodium intake resulted in 36,958 deaths in China, with males (26,171) being more affected than females (10,786). The ASMR was significantly higher in males (2.71 per 100,000) than in females (0.99 per 100,000). DALYs totaled 883,435, with males contributing 643,008 and females 240,427. Age-standardized DALY rates were 62.16 for males and 22.15 for females. The age-standardized rates for YLDs and YLLs were also higher in males than females. Although ASMR and age-standardized DALYs rates declined overall (AAPC: -2.45% and -2.76%, respectively), absolute burden increased due to aging and population growth. Compared to global averages, China's age-standardized rates remained higher, despite notable improvements since 1990. APC analysis showed elevated risks in older age groups, declining period effects, and lower burden among recent birth cohorts. Decomposition analysis indicated that aging and population growth contributed to increased deaths, while epidemiological changes led to a reduction. Despite declining age-standardized rates, the absolute burden of stomach cancer linked to high sodium remains substantial in China. Males and older adults are disproportionately affected. Population aging and growth are key contributors, while public health interventions have mitigated the burden to some extent. Sustained, gender-sensitive strategies focused on sodium reduction are essential to further lower disease impact.

Background Gallbladder and biliary tract cancer (GBTC) is a significant health burden in China, exacerbated by the rising prevalence of high body mass index (BMI). Understanding the trends and factors contributing to mortality and disability associated with GBTC is crucial for targeted public health interventions. Methods We utilized data from the Global Burden of Disease (GBD) Study to assess the burden of GBTC attributable to high BMI in China from 1990 to 2021. Age-standardized rates of deaths, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) were analyzed. Joinpoint regression and decomposition analyses were conducted to evaluate trends and identify contributing factors, including aging, population growth, and epidemiological changes. Gender-specific differences were also assessed. Results In 2021, GBTC deaths attributable to high BMI in China reached 4,053, with males experiencing a higher overall burden than females, particularly in older age groups. While females showed a higher mortality and overall burden in the 60 to 79 age range, this trend reversed in older age brackets, with males experiencing steeper increases in mortality and disability-related indicators beyond age 80. The age-standardized DALYs rate mirrored this pattern, with higher rates in males in advanced age groups. From 1990 to 2021, China saw a steady increase in GBTC burden attributable to high BMI, contrasting with a global decline. Joinpoint analysis indicated marked rises in mortality and DALYs rates after 2005, especially in males. Decomposition analysis identified population growth and aging as major drivers of increased deaths, while epidemiological changes primarily contributed to rising DALYs, with a stronger impact observed in males. Conclusions The burden of GBTC attributable to high BMI in China has increased substantially over the last three decades, driven by population growth, aging, and epidemiological shifts. The trends highlight a growing gender disparity, with males experiencing a greater rise in mortality and disability. Public health strategies targeting obesity and metabolic risk factors are critical to mitigating the increasing GBTC burden.

Background Gallbladder and biliary tract cancer (GBTC) poses a growing public health challenge in China, with considerable disparities across age and sex. Understanding long-term epidemiological patterns is essential for informing cancer control strategies and future projections. Methods Data from the Global Burden of Disease Study 2021 were used to assess GBTC burden in China from 1990 to 2021. Indicators analyzed included incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs). Joinpoint regression, age-period-cohort (APC) analysis, decomposition analysis, and Bayesian APC (BAPC) models were employed to explore temporal trends and project future burden through 2030. Results In 2021, China reported 51,720 new GBTC cases, with an age-standardized incidence rate (ASIR) of 2.49 per 100,000. Males exhibited higher burden than females across all indicators. Incidence, prevalence, mortality, and DALYs were highest in older age groups. From 1990 to 2021, China experienced increasing trends in incidence and prevalence, while age-standardized mortality rates (ASMR) declined. Compared to global trends, China's ASIR rose while global rates declined. DALYs decreased in both contexts but more steeply globally. Joinpoint regression revealed sex-specific shifts, with males showing consistent increases in incidence and females experiencing periods of both decline and rise. APC analysis highlighted increasing incidence among post-1950 birth cohorts and decreasing mortality in recent cohorts. Decomposition analysis indicated that rising incidence was driven by epidemiological changes and population growth, while mortality reduction was linked to medical improvements. BAPC models projected a continued rise in incidence, particularly among males. Conclusions The burden of GBTC in China is rising, especially among men and older adults. While mortality has improved, incidence continues to grow, highlighting the need for targeted prevention, early detection, and gender-specific public health policies.

Immunotherapy combined with chemotherapy has improved outcomes in advanced gastric cancer (GC), but reliable biomarkers to predict clinical benefit remain limited. Metabolomics provides a comprehensive assessment of systemic metabolic changes and may yield prognostic indicators to guide treatment selection. We performed untargeted liquid chromatography-tandem mass spectrometry (LC-MS/MS) metabolomics on baseline plasma from 40 patients with advanced GC receiving first-line programmed cell death protein-1 (PD-1) inhibitor plus chemotherapy. Patients were stratified into long-term survivors (LTS) and short-term survivors (STS) based on median overall survival (OS). Differential metabolites were identified using multivariate statistics, followed by univariate Cox regression and least absolute shrinkage and selection operator (LASSO) analysis to construct a metabolite-based risk score. Prognostic performance was evaluated using Kaplan-Meier analysis, time-dependent receiver operating characteristic (ROC) curves, and multivariate Cox models. Comparisons with conventional clinical factors were conducted, and a prognostic nomogram was developed. Proportional-hazards assumptions were assessed with Schoenfeld residuals; discrimination was optimism-corrected using 1,000-bootstrap resampling; Harrell's concordance index (C-index), time-dependent area under the curve (AUC), and bootstrap-corrected calibration curves were reported. Twelve-month decision-curve analysis (DCA) quantified net clinical benefit compared with clinicopathologic baselines. A total of 4,298 metabolites were detected, including 830 Level 1 and 1,321 Level 2 identifications. Principal component analysis and orthogonal partial least squares discriminant analysis showed clear separation between LTS and STS groups. Differential analysis revealed metabolites enriched in bile acid, amino acid, and retinol metabolism pathways. Cox and LASSO analyses identified six independent prognostic metabolites. The resulting metabolite-based risk score significantly stratified OS and progression-free survival ( < 0.01) and demonstrated stable predictive accuracy over 6-24 months. Compared with age, sex, tumor grade, and programmed death-ligand 1 combined positive score (PD-L1 CPS), the risk score showed superior discrimination. A nomogram integrating risk score, grade, and PD-L1 CPS yielded accurate OS predictions with strong calibration and higher net benefit in DCA. Internal validation supports the robustness of findings within this single-center, 40-patient cohort. A plasma metabolite-based risk score derived from six biomarkers independently predicts survival in advanced GC treated with PD-1-based immunotherapy and offers a practical tool for individualized prognosis.