National Brain Tumour Registry of China (NBTRC) statistical report of primary brain tumours diagnosed in China in years 2019-2020

Dan Xiao; Changxiang Yan; Deling Li; Tianshu Xi; Xianzhi Liu; Dan Zhu; Guodong Huang; Jianguo Xu; Zhengwen He; Anhua Wu; Chiyuan Ma; Jiang Long; Kai Shu; Hongming Ji; Ning Wang; Gang Chen; Jiankai Yang; Hui Ma; Zhiyong Li; Xiaochuan Sun; Yan Qu; Zhixiong Liu; Xiaofan Jiang; Chunlei Tian; Shilei Ni; Renya Zhan; Liwen Chen; Ming Ge; Maode Wang; Xiaobing Jiang; Geng Guo; Zhenmin Han; Chuan Zhang; Tingrong Zhang; Changwu Dou; Liangzhao Chu; Pengcheng Wang; Junfei Shao; Xiyue Wu; Ju Yu; Yu Wang; Nan Wu; Rui Zhang; Mingming Zhang; Yong Hong; Jianzhong Gao; Yunqian Li; Yawen Pan; Bing Zhao; Nan Ji; Guangliang Shan; Chirag B Patel; Wang Jia; Liwei Zhang

doi:10.1016/j.lanwpc.2023.100715

National Brain Tumour Registry of China (NBTRC) statistical report of primary brain tumours diagnosed in China in years 2019-2020

Lancet Reg Health West Pac. 2023 Feb 21:34:100715. doi: 10.1016/j.lanwpc.2023.100715. eCollection 2023 May.

Authors

Dan Xiao¹, Changxiang Yan², Deling Li^{1

3

4}, Tianshu Xi¹, Xianzhi Liu⁵, Dan Zhu⁶, Guodong Huang⁷, Jianguo Xu⁸, Zhengwen He⁹, Anhua Wu¹⁰, Chiyuan Ma¹¹, Jiang Long¹², Kai Shu¹³, Hongming Ji¹⁴, Ning Wang¹⁵, Gang Chen¹⁶, Jiankai Yang¹⁷, Hui Ma¹⁸, Zhiyong Li¹⁹, Xiaochuan Sun²⁰, Yan Qu²¹, Zhixiong Liu²², Xiaofan Jiang²³, Chunlei Tian²⁴, Shilei Ni²⁵, Renya Zhan²⁶, Liwen Chen²⁷, Ming Ge²⁸, Maode Wang²⁹, Xiaobing Jiang³⁰, Geng Guo³¹, Zhenmin Han³², Chuan Zhang³³, Tingrong Zhang³⁴, Changwu Dou³⁵, Liangzhao Chu³⁶, Pengcheng Wang³⁷, Junfei Shao³⁸, Xiyue Wu³⁹, Ju Yu⁴⁰, Yu Wang⁴¹, Nan Wu⁴², Rui Zhang⁴³, Mingming Zhang⁴⁴, Yong Hong⁴⁵, Jianzhong Gao⁴⁶, Yunqian Li⁴⁷, Yawen Pan⁴⁸, Bing Zhao⁴⁹, Nan Ji^{1

3

4}, Guangliang Shan⁵⁰, Chirag B Patel⁵¹, Wang Jia^{1

3

4}, Liwei Zhang^{1

3

4}

Affiliations

¹ China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China.
² Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China.
³ Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
⁴ Beijing Neurosurgical Institute, Beijing, China.
⁵ Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
⁶ Department of Neurosurgery, Guangdong 999 Brain Hospital, Guangzhou, China.
⁷ Department of Neurosurgery and Shenzhen Key Laboratory of Neurosurgery, Shenzhen University 1st Affiliated Hospital, Shenzhen Second People's Hospital, Shenzhen, China.
⁸ Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.
⁹ Department of Neurosurgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
¹⁰ Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China.
¹¹ Department of Neurosurgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China.
¹² Department of Neurosurgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
¹³ Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
¹⁴ Department of Neurosurgery, Shanxi Medical University Shanxi Provincial People's Hospital, Taiyuan, China.
¹⁵ Department of Neurosurgery, the First Affiliated Hospital of Harbin Medical University, Harbin, China.
¹⁶ Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China.
¹⁷ Department of Neurosurgery, the Second Hospital of Hebei Medical University, Shijiazhuang, China.
¹⁸ Department of Neurosurgery, Ningxia Medical University General Hospital, Yinchuan, China.
¹⁹ Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
²⁰ Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
²¹ Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
²² Department of Neurosurgery, Xiangya Hospital of Central South University, Changsha, China.
²³ Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
²⁴ Department of Neurosurgery, Institute of Neurosurgery, Yichang Central People's Hospital & The First Clinical Medical College of Three Gorges University, Yichang, China.
²⁵ Department of Neurosurgery, Qilu Hospital and Institute of Brain and Brain-Inspired Science, Cheeloo College of Medicine, Shandong University, Jinan, China.
²⁶ Department of Neurosurgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
²⁷ Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
²⁸ Department of Neurosurgery, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China.
²⁹ Department of Neurosurgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
³⁰ Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
³¹ Department of Neurosurgery, the First Hospital, Shanxi Medical University, Taiyuan, China.
³² Department of Neurosurgery, Affiliated Hospital of Chifeng University, Chifeng, China.
³³ Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China.
³⁴ Department of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
³⁵ Department of Neurosurgery, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.
³⁶ Department of Neurosurgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, China.
³⁷ Department of Neurosurgery, Hainan Provincial People's Hospital, Haikou, China.
³⁸ Department of Neurosurgery, Wuxi People's Hospital of Nanjing Medical University, Wuxi, China.
³⁹ Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
⁴⁰ Department of Neurosurgery, the Second Affiliated Hospital of Soochow University, Suzhou, China.
⁴¹ Department of Neurosurgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
⁴² Department of Neurosurgery, Chongqing Hospital Affiliated to University of Chinese Academy of Science/Chongqing General Hospital, Chongqing, China.
⁴³ Department of Neurosurgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
⁴⁴ Department of Neurosurgery, The Second Xiangya Hospital of Central South University, Changsha, China.
⁴⁵ Department of Neurosurgery, Chengde Central Hospital, Chengde, China.
⁴⁶ Department of Neurosurgery, First Hospital of Yulin, Yulin, China.
⁴⁷ Department of Neurosurgery, First Hospital of Jilin University, Changchun, China.
⁴⁸ Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China.
⁴⁹ Department of Neurosurgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
⁵⁰ Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China.
⁵¹ Department of Neuro-Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Abstract

Background: The lack of a well-designed brain tumour registry with standardized pathological diagnoses in underdeveloped countries hinders the ability to compare epidemiologic data across the globe. The National Brain Tumour Registry of China (NBTRC), created in January 2018, is the first multi-hospital-based brain tumour registry in China. Patient data reported to the NBTRC in years 2019-2020 were assessed.

Methods: Tumour pathology was based on the 2016 World Health Organization (WHO) classification of tumours of the central nervous system and ICD-O-3. The anatomical site was coded per the Surveillance, Epidemiology, and End Results (SEER) solid tumour module (version of July 2019). The cases were tabulated by histology and anatomical site. Categorical variables were reported as numbers (percentages). The distribution of tumours by age (0-14, 15-19, 20-39, 40-64, and 65+ years) was analysed.

Findings: There were a total of 25,537 brain tumours, foremost among them meningioma (23.63%), followed by tumours of the pituitary (23.42%), and nerve sheath tumours (9.09%). Glioblastoma, the most common and lethal form of primary brain cancer in adults, represented 8.56% of all cases. Of note, 6.48% of the malignant tumours were located in the brain stem. The percentage of malignant brain tumours decreased with increasing age, 24.08% in adults (40+ years), 30.25% in young adults (20-39 years), 35.27% in adolescents (15-19 years), and 49.83% in children (0-14 years). Among the 2107 paediatric patients, the most common sites were ventricle (17.19%), brainstem (14.03%), pituitary and craniopharyngeal duct (13.4%), and cerebellum (12.3%), a distribution that differed from that of the entire cohort. The histology distribution was also unique in children, with glioblastoma much less incident compared to the whole cohort (3% vs. 8.47%, p < 0.01). 58.80% of all patients chose higher-level neurosurgical hospitals outside of their province of residence. The median in-hospital length of stay (LOS) for the various pathologies ranged from 11 to 19 days.

Interpretation: The histological and anatomical site distribution of brain tumours in the NBTRC was statistically different in the subgroup of children (0-14 years). Patient choice of pursuing trans-provincial treatment was common and the in-hospital LOS was longer compared to that reported in similar European and American patient populations, which merits further attention.

Funding: The National Key Research and Development Program of China (2015BAI12B04, 2013BAI09B03, 2014BAI04B01, and 2021YFF1201104) and Chinese National Natural Science Foundation of China (81971668).

Keywords: Brain tumor; China; Distribution; Registry.