Adekolujo Orimisan Samuel, Tadisina Shourya, Koduru Ujwala, Gernand Jill, Smith Susan Jane, Kakarala Radhika Ramani
1 McLaren Flint, Flint, MI, USA.
2 Michigan State University, East Lasing, MI, USA.
Am J Mens Health. 2017 Jul;11(4):1190-1199. doi: 10.1177/1557988316669044. Epub 2016 Sep 29.
The effect of marital status (MS) on survival varies according to cancer type and gender. There has been no report on the impact of MS on survival in male breast cancer (MBC). This study aims to determine the influence of MS on tumor stage at diagnosis and survival in MBC. Men with MBC ≥18 years of age in the SEER database from 1990 to 2011 were included in the study. MS was classified as married and unmarried (including single, divorced, separated, widowed). Kaplan-Meier method was used to estimate the 5-year cancer-specific survival. Multivariate regression analyses were done to determine the effect of MS on presence of Stage IV disease at diagnosis and on cancer-specific mortality. The study included 3,761 men; 2,647 (70.4%) were married. Unmarried men were more often diagnosed with Stage IV MBC compared with married (10.7% vs. 5.5%, p < .001). Unmarried men (compared with married) were significantly less likely to undergo surgery (92.4% vs. 96.7%, p < .001). Overall unmarried males with Stages II, III, and IV MBC have significantly worse 5-year cancer-specific survival compared with married. On multivariate analysis, being unmarried was associated with increased hazard of death (HR = 1.43, p < .001) and increased likelihood of Stage IV disease at diagnosis ( OR = 1.96, p < .001). Unmarried males with breast cancer are at greater risk for Stage IV disease at diagnosis and poorer outcomes compared with married males.
婚姻状况(MS)对生存率的影响因癌症类型和性别而异。目前尚无关于婚姻状况对男性乳腺癌(MBC)生存率影响的报道。本研究旨在确定婚姻状况对MBC诊断时肿瘤分期及生存率的影响。研究纳入了1990年至2011年SEER数据库中年龄≥18岁的MBC男性患者。婚姻状况分为已婚和未婚(包括单身、离婚、分居、丧偶)。采用Kaplan-Meier法估计5年癌症特异性生存率。进行多变量回归分析以确定婚姻状况对诊断时IV期疾病的存在及癌症特异性死亡率的影响。该研究纳入了3761名男性;其中2647名(70.4%)已婚。与已婚男性相比,未婚男性更常被诊断为IV期MBC(10.7%对5.5%,p<.001)。未婚男性(与已婚男性相比)接受手术的可能性显著更低(92.4%对96.7%,p<.001)。总体而言,II期、III期和IV期MBC的未婚男性5年癌症特异性生存率明显低于已婚男性。多变量分析显示,未婚与死亡风险增加(HR=1.43,p<.001)及诊断时IV期疾病可能性增加(OR=1.96,p<.001)相关。与已婚男性相比,未婚男性乳腺癌患者诊断时IV期疾病风险更高,预后更差。