Oncological outcome after radical prostatectomy: Marital status does not make a difference

Abstract

Objectives: To examine the impact of marital status on prostate cancer characteristics at radical prostatectomy and oncological outcome after surgery at a high-volume center. Methods: We relied on the Martini-Clinic Prostate Cancer database and investigated 8088 prostate cancer patients treated with radical prostatectomy between January 2000 and March 2011. We analyzed differences in clinical and pathological characteristics according to marital status (married and partnership vs single). Additionally, we relied on multivariable Cox regression analyses to predict biochemical recurrence, metastases and death after radical prostatectomy. Finally, Kaplan-Meier analyses were used in a propensity score-matched cohort, adjusted for clinical and pathological characteristics, to examine differences in biochemical recurrence-free, metastases-free and overall survival according to marital status. Results: According to marital status, no significant differences were recorded within clinical and pathological characteristics (all P > 0.05). The impact of marital status on biochemical recurrence (hazard ratio 1.0, 95% confidence interval 0.9-1.3, P = 0.7), metastases (hazard ratio 1.3, 95% confidence interval 0.8-2.1, P = 0.3) and death (hazard ratio 0.8, 95% confidence interval 0.4-1.6, P = 0.6) after radical prostatectomy was not significant (median follow up 48 months). Kaplan-Meier analyses recorded no significant differences for biochemical recurrence-free, metastases-free and overall survival (all log-rank P > 0.05) according to marital status. Conclusions: Marital status does not affect the clinical and pathological characteristics of radical prostatectomy patients treated at a high-volume center. Furthermore, marital status does not affect biochemical recurrence-free and metastases-free survival after radical prostatectomy.

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

“…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).…”

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

“…The effect of marital status on the survival of patients with PCa who have undergone RP has been studied using SEER and the Martini-Clinic Prostate Cancer database ( 8 , 11 ). However, the results of these investigations have not been consistent and no studies have been conducted focusing on the heterogeneity of unmarried patients.…”

“…Similarly, another study ( 10 ) consisting of 3,570 patients with PCa treated in three prospective Radiation Therapy Oncology Group clinical trials revealed that the survival rates of unmarried individuals were significantly decreased compared with married individuals. However, a study by Schiffmann et al ( 11 ) using the Martini-Klinik Prostate Cancer database indicated that married men with PCa did not have a significantly higher OS rate compared with SDW men over follow-up period of 48 months.…”

“…All of these indicate that the heterogeneity of unmarried individuals may somewhat influence the predictive value. However, previous studies ( 8 – 11 ) compared the survival outcomes of patients with PCa in terms of marital status without differentiating separated, divorced and widowed status. Several of these studies ( 9 – 11 ) did not even distinguish between patients that had never married and those that were SDW.…”

“…However, previous studies ( 8 – 11 ) compared the survival outcomes of patients with PCa in terms of marital status without differentiating separated, divorced and widowed status. Several of these studies ( 9 – 11 ) did not even distinguish between patients that had never married and those that were SDW. In addition, the proportion of married individuals in the population, the prostate specific antigen (PSA) based screening strategy, mortality rate, surgical equipment, as well as the guidelines, including AUA ( 13 ) and EAU ( 14 , 15 ), have changed, which may affect the impact of marital status on patient outcomes ( 16 , 17 ).…”