Saito-Nakaya Kumi, Nakaya Naoki, Akechi Tatsuo, Inagaki Masatoshi, Asai Mariko, Goto Koichi, Nagai Kanji, Nishiwaki Yutaka, Tsugane Shoichiro, Fukudo Shin, Uchitomi Yosuke
Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
Psychooncology. 2008 Sep;17(9):869-76. doi: 10.1002/pon.1296.
Previous studies have suggested that marital status is associated with survival from lung cancer; however, its association is not conclusive. The association between marital status and survival in Japanese patients with non-small cell lung cancer (NSCLC) was prospectively investigated.
Between July 1999 and July 2004, a total of 1230 NSCLC patients were enrolled. The baseline survey consisted of the collection of clinical information and various demographic data, including marital status. A Cox regression model was used to estimate the hazards ratio (HR) of all-cause mortality adjustments for age, BMI, education level, performance status, histology type, clinical stage, smoking status, choice of definitive treatment, and depression.
The multivariable adjusted HR of male widowed patients versus male married patients was 1.7 (95% confidence interval=1.2-2.5, p=0.005). However, no significant increased risk of death in female widowed patients compared with female married patients was observed (HR=0.7, 95% confidence interval=0.5-1.1, p=0.15). With regard to separated/divorced and single patients no significant increased risk of death in male and/or female compared with married patients was observed.
The present data suggest that male widowed patients with NSCLC have a higher mortality rate than male married patients with NSCLC, after controlling for various factors.
既往研究表明婚姻状况与肺癌生存率相关;然而,其关联并不确凿。本研究前瞻性调查了日本非小细胞肺癌(NSCLC)患者的婚姻状况与生存率之间的关联。
1999年7月至2004年7月期间,共纳入1230例NSCLC患者。基线调查包括收集临床信息和各种人口统计学数据,包括婚姻状况。采用Cox回归模型估计年龄、体重指数、教育水平、体能状态、组织学类型、临床分期、吸烟状况、确定性治疗选择和抑郁等因素调整后的全因死亡率风险比(HR)。
男性丧偶患者与男性已婚患者相比,多变量调整后的HR为1.7(95%置信区间=1.2 - 2.5,p = 0.005)。然而,未观察到女性丧偶患者与女性已婚患者相比死亡风险显著增加(HR = 0.7,95%置信区间=0.5 - 1.1,p = 0.15)。对于分居/离婚和单身患者,未观察到男性和/或女性与已婚患者相比死亡风险显著增加。
目前的数据表明,在控制各种因素后,男性丧偶的NSCLC患者比男性已婚的NSCLC患者死亡率更高。