Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, Missouri.
Saint Louis University Cancer Center, St. Louis, Missouri.
Eur J Cancer Care (Engl). 2019 Jul;28(4):e13022. doi: 10.1111/ecc.13022. Epub 2019 Feb 19.
To determine whether marital status independently predicts survival in a head and neck cancer (HNC) survivor population.
In this retrospective cohort study, we analysed data from 460 adult patients (59.31 ± 11.42) years diagnosed with HNC at an academic tertiary referral centre between 1997 and 2012. Cox proportional hazards model estimated the effect of marital status on survival.
Our study had 73% men, and 82.2% were Whites. We found an association between marital status and HNC survival. Unmarried HNC patients had a 66% increase in hazard of death compared to married patients (aHR = 1.66, 95% CI = 1.23-2.23). This was after controlling for sociodemographic variables (age, race, sex and health insurance status), social habits (tobacco and alcohol), primary anatomical subsite (oral cavity, oropharyngeal, laryngeal and others), stage at presentation (early vs. late stage) and treatment modality (surgery, surgery with adjuvant therapies, other single modality therapy and palliative care).
Being married confers survival advantage for HNC survivors. Our finding underscores the need to recognise this aspect of survivorship. Social support should be considered part of standard care for managing HNC. There may also be need to develop other support mechanisms, especially for unmarried HNC survivors.
确定婚姻状况是否能独立预测头颈部癌症(HNC)幸存者的生存情况。
在这项回顾性队列研究中,我们分析了 1997 年至 2012 年间在一家学术性三级转诊中心被诊断患有 HNC 的 460 名成年患者(59.31±11.42 岁)的数据。Cox 比例风险模型估计了婚姻状况对生存的影响。
我们的研究中有 73%的男性,82.2%为白人。我们发现婚姻状况与 HNC 生存之间存在关联。与已婚患者相比,未婚 HNC 患者的死亡风险增加了 66%(aHR=1.66,95%CI=1.23-2.23)。这是在控制了社会人口统计学变量(年龄、种族、性别和医疗保险状况)、社会习惯(烟草和酒精)、主要解剖亚部位(口腔、口咽、喉和其他部位)、就诊时的分期(早期与晚期)以及治疗方式(手术、手术联合辅助治疗、其他单一治疗方式和姑息治疗)之后得出的结果。
已婚状态为 HNC 幸存者带来了生存优势。我们的发现强调了需要认识到这一生存方面。社会支持应被视为管理 HNC 标准护理的一部分。可能还需要开发其他支持机制,特别是针对未婚的 HNC 幸存者。