Marital status and survival in patients with rectal cancer: An analysis of the Surveillance, Epidemiology and End Results (SEER) database

Wang, Xiangyang; Cao, Weilan; Zheng, Chenguo; Hu, Wanle; Liu, Changbao

doi:10.1016/j.canep.2018.04.007

Cited by 57 publications

(46 citation statements)

References 33 publications

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“…Consistent with this finding, a survival advantage was observed among married patients in our study ( P < 0.001). Possible reasons for this survival advantage are that married patients are more likely to undergo cancer screening, be diagnosed at earlier stages, experience better financial support, and receive the recommended treatment . In our cohort, radiotherapy was significantly more common among patients who were married than among those who were single or widowed/divorced ( P = 0.006).…”

Section: Discussionmentioning

confidence: 79%

Role of postoperative radiotherapy in pT3N0 rectal cancer: A risk‐stratification system based on population analyses

Huang

Lin

et al. 2019

Cancer Medicine

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The impact of adjuvant radiotherapy in pT3N0 rectal cancer is controversial. We aimed to determine the risk factors for cancer‐specific survival (CSS) among these patients and to develop a risk‐stratification system to identify which of these patients would benefit from adjuvant radiotherapy. In this review of the Surveillance, Epidemiology, and End Results database (2010‐2014), we analyzed the data of pT3N0 rectal cancer patients who had not undergone neoadjuvant radiotherapy. Prognostic factors were identified using the Cox proportional hazards model, and risk scores were derived according to the β regression coefficient. A total of 1021 patients were identified from the database search. The overall 5‐year CSS was 86.31%. Multivariate analysis showed that age (P < 0.001), tumor differentiation (P = 0.044), number of nodes resected (P = 0.032), marital status (P = 0.005), and radiotherapy (P = 0.006) were independent prognostic factors for CSS. A risk‐stratification system composed of age, tumor differentiation, and number of nodes resected was generated. Low‐risk patients had better CSS than high‐risk patients (92.13% vs 72.55%, P < 0.001). The addition of radiotherapy to surgery doubled the CSS among the high‐risk patients (42.06% vs 91.26%, P = 0.001) but produced no survival benefit among the low‐risk patients (93.36% vs 96.38%, P = 0.182). Our risk‐stratification model based on age, tumor differentiation, and number of nodes resected predicted the outcomes of pT3N0 rectal cancer patients. This model could help identify patients who may benefit from adjuvant radiotherapy.

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Section: Discussionmentioning

confidence: 79%

Role of postoperative radiotherapy in pT3N0 rectal cancer: A risk‐stratification system based on population analyses

Huang

Lin

et al. 2019

Cancer Medicine

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“…Our findings related to female gender being an independent risk factor associated with elevated CEA level are unique and need further stratification to show any association with age, race or ethnicity. Analysis of SEER data has shown that marital status at diagnosis has been well-associated as an independent factor for poor prognosis in many types of cancers, (34)(35)(36)(37)(38) including colorectal cancer (39). Often, this is explained by social support mechanisms available for patients who are married at the time of diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of carcinoembryonic antigen-producing colorectal cancers: A population based study

Groover¹,

Kaul²,

Johnston³

et al. 2019

Arch Oncol

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“…Marriage has a protective effect on the outcome in small intestine adenocarcinoma, which is consistent with recent reports. 10 – 13 Married patients have better 5-year OS and CSS than unmarried patients, including single (never married), widowed, divorced, separated, and unmarried or domestic partner patients. After adjusting for age, insurance status, tumor primary site, TNM stage, tumor grade, tumor histology, and surgery, the multivariate Cox proportional hazards model showed that marital status was an independent prognostic factor for OS and CSS in small intestine adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

“… 21 – 23 Unmarried patients also tend to have latter stages of disease. 13 Hershman et al 24 reported that unmarried patients were more likely to delay the initiation of adjuvant chemotherapy after breast cancer surgery, leading to higher mortality. Our results are in line with those of previous studies, as we found a higher percentage of stage IV disease in unmarried patients than in married patients and that unmarried patients were less likely to receive surgery than married patients (55.9 vs 66.0%, P <0.001).…”

Section: Discussionmentioning

confidence: 99%

“…Marital status was reported to be associated with survival in some cancers, such as renal cell carcinoma, 10 head and neck cancers, 11 squamous cell carcinoma of the penis, 12 and rectal cancer. 13 However, other studies could not find any protective effect of marriage on patients’ outcome. 14 , 15 Previous study by Kato et al 16 found that single females showed increased risks for small intestine cancers.…”

Section: Introductionmentioning

confidence: 94%

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Influence of marital status on small intestinal adenocarcinoma survival: an analysis of the Surveillance, Epidemiology, and End Results (SEER) database

Chen

Cui

Dai

et al. 2018

CMAR

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AimNo studies have been published on the relationship between marital status and outcomes in small intestinal cancers. The present study was conducted to explore the influence of marital status on small intestinal adenocarcinoma survival based on the Surveillance, Epidemiology, and End Results (SEER) database.MethodsData from eligible patients diagnosed with small intestinal adenocarcinoma between 2004 and 2015 were extracted from the SEER database. Patients were categorized into married group (including common law) and unmarried group (including single [never married], widowed, divorced, separated, and unmarried or domestic partner). The primary endpoints were 5-year overall survival (OS) and 5-year cancer-specific survival (CSS). A survival curve was generated by the Kaplan–Meier method, and the survival rate differences were estimated by a log-rank test. A multivariate Cox proportional hazard model was used to evaluate the independent risk factors for survival.ResultsA total of 6,747 small intestinal adenocarcinoma patients were enrolled, including 3,862 married and 2,885 unmarried patients. The 5-year OS and 5-year CSS were significantly greater in married patients than in unmarried patients (27.1 vs 18.8% for OS and 45.7 vs 39.3% for CSS, both P<0.001). After adjusting for age, insurance status, tumor primary site, TNM stage, tumor grade, tumor histology, and surgery, the multivariate Cox proportional hazards model showed that marriage is an independent protective factor for OS (HR =0.789, 95% CI: 0.745–0.836, P<0.001) and CSS (HR =0.794, 95% CI: 0.736–0.857, P<0.001).ConclusionMarried small intestinal adenocarcinoma patients have better OS and CSS than unmarried patients. Psychological and economic supports from the spouses of married patients may contribute to improvements in survival.

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Marital status and survival in patients with rectal cancer: An analysis of the Surveillance, Epidemiology and End Results (SEER) database

Cited by 57 publications

References 33 publications

Role of postoperative radiotherapy in pT3N0 rectal cancer: A risk‐stratification system based on population analyses

Role of postoperative radiotherapy in pT3N0 rectal cancer: A risk‐stratification system based on population analyses

Characteristics of carcinoembryonic antigen-producing colorectal cancers: A population based study

Influence of marital status on small intestinal adenocarcinoma survival: an analysis of the Surveillance, Epidemiology, and End Results (SEER) database

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