Bai Dou-Sheng, Chen Ping, Qian Jian-Jun, Jin Sheng-Jie, Jiang Guo-Qing
Department of Department of Hepatobiliary and Pancreatic Surgery, Clinical Medical College of Yangzhou University, Yangzhou, China.
Oncotarget. 2017 Apr 18;8(16):26404-26413. doi: 10.18632/oncotarget.15476.
Marital status has been reported as an independent prognostic factor for survival in various cancers, but it has been rarely studied in gallbladder cancer treated by surgical resection. We retrospectively studied Surveillance, Epidemiology, and End Results (SEER) population-based data and identified 9,041 cases of gallbladder cancer with surgical treatment between 1988 and 2013. The patients were categorized according to marital status, as "married," "never married," "widowed," or "divorced/separated." Patients in the widowed group had a higher proportion of women within-group comparisons, a higher rate of white race, a greater proportion of older (≥ 60 years) patients, more frequency of adenocarcinoma, a greater number of tumors at well/moderate pathological grading, and more prevalence at the localized SEER stage, all of which were statistically significant (P < 0.001). Marital status was confirmed to be an independent prognostic factor by multivariate analysis (P < 0.001). Married patients had higher 5-year gallbladder cancer cause-specific survival than unmarried patients (P < 0.001); conversely, widowed patients had the lowest gallbladder cancer cause-specific survival compared with all other patients. Conclusions marital status is an important prognostic risk factor for survival in patients with gallbladder cancer treated with surgical resection. Widowed patients have the highest risk of death compared with other groups.
婚姻状况已被报道为多种癌症生存的独立预后因素,但在接受手术切除治疗的胆囊癌中却鲜有研究。我们回顾性研究了基于监测、流行病学和最终结果(SEER)的人群数据,确定了1988年至2013年间9041例接受手术治疗的胆囊癌病例。患者根据婚姻状况分为“已婚”“未婚”“丧偶”或“离异/分居”。丧偶组患者在组内比较中女性比例更高、白人种族比例更高、年龄较大(≥60岁)的患者比例更大、腺癌发生率更高、病理分级为高/中分化的肿瘤数量更多、在SEER局部阶段的患病率更高,所有这些均具有统计学意义(P<0.001)。多因素分析证实婚姻状况是独立的预后因素(P<0.001)。已婚患者的胆囊癌特定病因5年生存率高于未婚患者(P<0.001);相反,与所有其他患者相比,丧偶患者的胆囊癌特定病因生存率最低。结论婚姻状况是接受手术切除治疗的胆囊癌患者生存的重要预后风险因素。与其他组相比,丧偶患者的死亡风险最高。