婚姻对老年头颈癌患者治疗结果的影响。

Effect of marriage on outcomes for elderly patients with head and neck cancer.

作者信息

Schaefer Eric W, Wilson Matthew Z, Goldenberg David, Mackley Heath, Koch Wayne, Hollenbeak Christopher S

机构信息

Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.

出版信息

Head Neck. 2015 May;37(5):735-42. doi: 10.1002/hed.23657. Epub 2014 Jun 18.

DOI:10.1002/hed.23657

PMID:24596027

Abstract

BACKGROUND

Beneficial effects of marriage on cancer outcomes have been observed for many cancers, but oral cavity and pharyngeal cancers have never been examined.

METHODS

We used the National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) Program linked with Medicare records to identify 9403 elderly patients (age ≥66 years) with oral cavity and pharyngeal cancers. We used a propensity score analysis to estimate differences in proportions (pd ) between married and unmarried patients on stage, treatment, and survival.

RESULTS

For oral cavity cancers, a larger proportion of married patients presented with earlier stage (pd = 0.05; 95% confidence interval [CI], 0.02-0.08), were treated with surgery (pd = 0.06; 95% CI, 0.03-0.08), and survived 1 year (pd = 0.04; 95% CI, 0.01-0.06). Similar results were found for pharyngeal cancers for stage (pd = 0.04; 95% CI, 0.01-0.06), treatment with chemotherapy and radiation (pd = 0.04; 95% CI, 0.01-0.07), and 1-year survival (pd = 0.01; 95% CI, 0.08-0.16).

CONCLUSION

Marriage is associated with earlier stage, aggressive treatment, and superior survival for patients with oral cavity and pharyngeal cancers.

摘要

背景

婚姻对多种癌症的预后具有有益影响，但口腔癌和咽癌尚未得到研究。

方法

我们利用美国国立癌症研究所（NCI）的监测、流行病学和最终结果（SEER）计划与医疗保险记录相链接，以识别9403名患有口腔癌和咽癌的老年患者（年龄≥66岁）。我们采用倾向得分分析来估计已婚和未婚患者在分期、治疗和生存方面的比例差异（pd）。

结果

对于口腔癌，已婚患者中更大比例的人表现为早期阶段（pd = 0.05；95%置信区间[CI]，0.02 - 0.08），接受手术治疗（pd = 0.06；95% CI，0.03 - 0.08），且存活1年（pd = 0.04；95% CI，0.01 - 0.06）。对于咽癌，在分期（pd = 0.04；95% CI，0.01 - 0.06）、化疗和放疗治疗（pd = 0.04；95% CI，0.01 - 0.07）以及1年生存率（pd = 0.01；95% CI，0.08 - 0.16）方面发现了类似结果。