Marital Status, Living Arrangement, and Cancer Recurrence and Survival in Patients with Stage III Colon Cancer: Findings from CALGB 89803 (Alliance)

Abstract

Background Limited and conflicting findings have been reported regarding the association between social support and colorectal cancer (CRC) outcomes. We sought to assess the influences of marital status and living arrangement on survival outcomes among patients with stage III colon cancer. Patients and Methods We conducted a secondary analysis of 1082 patients with stage III colon cancer prospectively followed in the CALGB 89803 randomized adjuvant chemotherapy trial. Marital status and living arrangement were both self-reported at the time of enrollment as, respectively, married, divorced, separated, widowed, or never-married, and living alone, with a spouse or partner, with other family, in a nursing home, or other. Results Over a median follow-up of 7.6 years, divorced/separated/widowed patients experienced worse outcomes relative to those married regarding disease free-survival (DFS) (hazards ratio (HR), 1.44 (95% CI, 1.14-1.81); P =.002), recurrence-free survival (RFS) (HR, 1.35 (95% CI, 1.05-1.73); P = .02), and overall survival (OS) (HR, 1.40 (95% CI, 1.08-1.82); P =.01); outcomes were not significantly different for never-married patients. Compared to patients living with a spouse/partner, those living with other family experienced a DFS of 1.47 (95% CI, 1.02-2.11; P = .04), RFS of 1.34 (95% CI, 0.91-1.98; P = .14), and OS of 1.50 (95% CI, 1.00-2.25; P =.05); patients living alone did not experience significantly different outcomes. Conclusion Among patients with stage III colon cancer who received uniform treatment and follow-up within a nationwide randomized clinical trial, being divorced/separated/widowed and living with other family were significantly associated with greater colon cancer mortality. Interventions enhancing social support services may be clinically relevant for this patient population. Trial Registration ClinicalTrials.gov Identifier: NCT00003835

Establishment and validation of a prognostic nomogram for postoperative patients with gastric cardia adenocarcinoma: A study based on the Surveillance, Epidemiology, and End Results database and a Chinese cohort

“…In contrast, it has been suggested that younger patients may have a better tolerance to the adverse effects of treatment, including myelosuppression after chemotherapy, compared with that in elderly patients. Additionally, in this study, unmarried patients were more prone to anxiety and had greater stress burdens than married patients, thereby reducing their immune capacity and affecting their metabolic balance, resulting in decreased survival 26,27 . In addition, unmarried patients had poorer compliance with treatment and received the treatment later, which may also be a reason for their poor prognoses 28 …”

“…Additionally, in this study, unmarried patients were more prone to anxiety and had greater stress burdens than married patients, thereby reducing their immune capacity and affecting their metabolic balance, resulting in decreased survival. 26,27 In addition, unmarried patients had poorer compliance with treatment and received the treatment later, which may also be a reason for their poor prognoses. 28 Zhu et al observed that White patients had the highest risk of GCA compared with that in the other ethnic groups, which is consistent with our findings.…”

Can the genes communicate with each other after birth? An international cross‐sectional study

“…Studies suggest that persons with improved living status and social support have been shown to have a better outcome, decreased mortality, and an increased disease‐free interval. 6 Also, the quality of life is enhanced. Because the environment has a large influence on disease behavior, your living situation may have influenced the disease's recurrence.…”

“…Our study also finds a strong link between living status and disease recurrence ( p value of 0.01). Studies suggest that persons with improved living status and social support have been shown to have a better outcome, decreased mortality, and an increased disease‐free interval 6 . Also, the quality of life is enhanced.…”

Impact of Head and Neck Cancer Diagnosis and Treatment on Patient‐Partner Intimacy

“…Few studies have attempted to quantify relationship changes after cancer diagnosis, and no studies to date have sought to determine whether changes in relationship intimacy in HNSCC are associated with a diagnosis of HPV or the effects of cancer diagnosis and treatment. Multiple studies have demonstrated that relationship quality and satisfaction can affect patient and partner adjustment to cancer and that patients who are divorced or separated tend to have worse oncologic outcomes 17–22 . Therefore, understanding the impact of HNSCC on patient relationships may improve our approach to providing holistic cancer care.…”