婚姻状况对胆囊癌患者生存的影响：一项基于人群的研究。
The influence of marital status on survival of gallbladder cancer patients: a population-based study.
机构信息
Department of General Surgery, Changzheng Hospital, the Second Military Medical University, 415S, Fengyang Road, Shanghai, 200003, China.
Department of Blood Transfusion, Changzheng Hospital, the Second Military Medical University, 415S, Fengyang Road, Shanghai, 200003, China.
出版信息
Sci Rep. 2017 Jul 13;7(1):5322. doi: 10.1038/s41598-017-05545-0.
Marital status has been found to be a prognostic factor for survival in various cancers, but its role in gallbladder cancer (GBC) has not been fully studied. In this study, we used the Surveillance, Epidemiology, and End Results Program (SEER)-registered database to analyze the survival of GBC patients with different marital status. A total of 6,627 GBC patients were selected from SEER database from 2004 to 2013. The age, race, grade, histologic type, AJCC stage, SEER stage and marital status were identified as independent prognostic factors. Married GBC patients had a higher 5-year cancer-specific survival (CSS) than that of unmarried ones (20.1% v.s. 17.8%, P < 0.05). Subgroup analyses showed that widowed patients had 14.0% less of 5-year CSS compared to married ones of stage I (55.9% v.s. 41.9%, P < 0.05), 14.7% of stage II (15.6% v.s. 10.9%, P < 0.05), and 1.5% of stage III + IV (2.9% v.s. 1.4%, P < 0.05). In addition, single is an independent prognostic factor at stage III + IV (HR = 1.225, 95%CI 1.054-1.423, P = 0.008). These results indicated that widowed patients were at a high risk of cancer-specific mortality and marriage can be a protective prognostic factor in CSS.
婚姻状况已被发现是各种癌症生存的预后因素，但在胆囊癌（GBC）中的作用尚未得到充分研究。在这项研究中，我们使用监测、流行病学和最终结果计划（SEER）登记数据库分析了不同婚姻状况的 GBC 患者的生存情况。从 2004 年到 2013 年，我们从 SEER 数据库中选择了 6627 名 GBC 患者。年龄、种族、分级、组织学类型、AJCC 分期、SEER 分期和婚姻状况被确定为独立的预后因素。已婚 GBC 患者的 5 年癌症特异性生存率（CSS）高于未婚患者（20.1%比 17.8%，P<0.05）。亚组分析显示，与 I 期已婚患者相比，丧偶患者的 5 年 CSS 减少了 14.0%（55.9%比 41.9%，P<0.05），II 期减少了 14.7%（15.6%比 10.9%，P<0.05），III+IV 期减少了 1.5%（2.9%比 1.4%，P<0.05）。此外，单身是 III+IV 期的独立预后因素（HR=1.225，95%CI 1.054-1.423，P=0.008）。这些结果表明，丧偶患者癌症特异性死亡率高，婚姻是 CSS 的保护性预后因素。
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