Marital status independently predicts prostate cancer survival in men who underwent radical prostatectomy: An analysis of 95,846 individuals

Abstract

Abstract.Marital status is an independent prognostic factor for survival in several types of cancer, but has not been fully studied in prostate cancer (PCa). A total of 95,846 men diagnosed with PCa were treated with radical prostatectomy (RP) between 2004 and 2009 within 18 Surveillance, Epidemiology and End Results registries. Survival curves were generated using Kaplan-Meier estimates and differences in survival were assessed using the log-rank test. Cox regression models were used to assess the impact of marital status on survival outcomes. The results demonstrated that the 8-year cancer-cause specific survival (CSS) rate of married men was higher than unmarried individuals. Further analyses revealed that divorced/separated men had a higher proportion of high Gleason scores (GS) PCa at diagnosis [hazard ratio (HR), 1.12; P=0.007] and those patients had the worst survival outcomes independent of age, ethnicity, grade, stage and sequence number [HR, 1.61; 95% confidence interval (CI), 1.34-1.93]. Interestingly, it was observed that CSS among divorced/separated men decreased as the GS increased (GS≤6: HR, 2.5; GS=7: HR, 1.71; GS≥8: HR, 1.50; all P<0.05). Apart from that, no significant differences in CSS were observed in those who had never been married (HR, 1.20) or were widowed (HR, 1.13) relative to the married group. The results of the present study support the hypothesis that marital status is an independent prognostic factor among men with PCa who underwent RP. It was demonstrated that the mortality rates of divorced or separated men with PCa were significantly greater compared with the other groups. A further understanding of the potential associations among marital status, psychosocial factors and survival outcomes may help in developing novel, more effective methods of treating different groups of patients with PCa.

Clinicopathological characteristics and cancer-specific survival prediction of Large cell lung cencer: a population-based study

“…In this study,the routinely available characteristics of the patients were extracted from the database.Based on these,a nomogram was developed and validated.The model performance of the In agreement with other type of NSCLC,the age and sex were all important predictors for CSS of LCLC [13].Old age and male patients were associated with worse prognosis.In order to get better discrimination for the nomogram model,According to Harrell's guidelines,in this study,patients age were determined into two groups [14].Seventy-seven years old was the best cutoff point.At present,an consistent conclusion was not reached for the CSS disparities of patients with lung cancer for different race [15].In genaral,better CSS outcomes would be seen in race with higher health awareness,that the treatment in these races would be more active.In this study,as for LCLC,the significantly different influence of race for patient's CSS was seen both in univariable and multi-variable analysis.The CSS outcome for other race is better than the White race.Treatment activity might be a possible explanation for this phenomenon,another reason might be attributed to the sample of the SEER database,that small proportion of other race was collected in the database,which might affect the statistical results for this study.As a most common used tumor associated indices,the AJCC stage still contributed most for the established nomogram model,which is in line with other type of NSCLC [16].Tumour size is an important indicator for T stage,in this study,its was also found to be an independent risk factor for LCLC.It could be confirmed that patients with a tumour size >41mm show less CSS time than that <=41mm with the maximally selected rank statistics.Surgery is the domain treatment for many type of lung cancer.In this study,surgery was also found to be an important treatment for LCLC that patients with surgery had a greatly decrease in cancer-specific death.Marital status has been confirmed to be associated with the CSS in a series of cancer [17][18][19][20][21].This phenomenon, in our present study was consistent with the previous study that married LCLC patients represented for lower nomogram scores had CSS benefit compared with other types of marital status.…”

Nomograms Predict Survival Advantages of Gleason Score 3+4 Over 4+3 for Prostate Cancer: A SEER-Based Study

“…Consistent with previous reports and the risk grading of the NCCN guidelines (26), the highest level (>20 ng/ml) showed the lowest survival advantage in patients with Gleason score 7 tumors. Marital status, as a pivotal social exterior factor for cancer patents, has been investigated the associations with outcomes of prostate cancer patients previously (27–29). Although marital status does not affect biochemical recurrence-free and metastases-free survival after radical prostatectomy (28), it is reported to be an independent predictor of OS and CSS in men with prostate cancer, which is consistent with our study (27, 29).…”

Association of neck dissection with survival for early stage N0 tongue cancer

“…Moreover, married patients are also more likely than unmarried patients to have better family financial status, to seek treatment at more prestigious medical facilities, and to comply with medication recommendations. Furthermore, existing literature has shown that marital status is an independent prognostic factor for survival in many cancers, including breast cancer, [35] gastric cancer, [36] colorectal cancer, [37] prostate cancer, [38] pancreatic cancer, [39] etc. Therefore, more social and psychological supports should be provided for unmarried patients.…”