Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China.
BMC Endocr Disord. 2020 Jul 23;20(1):111. doi: 10.1186/s12902-020-00565-w.
Marital status proves to be an independent prognostic factor in a variety of cancers. However, its prognostic impact on gastric neuroendocrine neoplasms (G-NEN) has not been investigated.
We identified 3947 G-NEN patients from the Surveillance, Epidemiology, and End Results (SEER) database. Meanwhile, propensity scores for marital status were used to match 506 unmarried patients with 506 married patients. We used Kaplan-Meier method and multivariate Cox regression to analyse the association between marital status and the overall survival (OS) and G-NEN cause-specific survival (CSS) before matching and after matching.
Married patients enjoyed better OS and CSS, compared with divorced/separated, single, and widowed patients. Multivariate Cox regression analysis indicated that unmarried status was associated with higher mortality hazards for both OS and CSS among G-NEN patients. Additionally, widowed individuals had the highest risks of overall (adjusted hazard ratio (HR): 1.56, 95% confidence interval (CI): 1.35-1.81, P < 0.001) and cancer-specific mortality (adjusted HR: 1.33, 95% CI: 1.05-1.68, P = 0.02) compared to other unmarried groups in both males and females. Furthermore, unmarried status remained an independent prognostic and risk factor for both OS (HR 1.51, 95% CI 1.19-1.90, P = 0.001) and CSS (HR 1.50, 95% CI 1.10-2.05, P = 0.01) in 1:1 propensity score-matched analysis.
Marital status was an independent prognostic factor for G-NEN. Meanwhile, widowed patients with G-NEN had the highest risk of death compared with single, married, and divorced/separated patients.
婚姻状况被证明是多种癌症的独立预后因素。然而，其对胃神经内分泌肿瘤（G-NEN）的预后影响尚未得到研究。
我们从监测、流行病学和最终结果（SEER）数据库中确定了 3947 名 G-NEN 患者。同时，使用婚姻状况倾向评分对 506 名未婚患者和 506 名已婚患者进行匹配。我们使用 Kaplan-Meier 方法和多变量 Cox 回归分析在匹配前和匹配后分析婚姻状况与总生存（OS）和 G-NEN 特异性生存（CSS）之间的关系。
与离婚/分居、单身和丧偶患者相比，已婚患者的 OS 和 CSS 更好。多变量 Cox 回归分析表明，未婚状态与 G-NEN 患者的 OS 和 CSS 死亡率升高相关。此外，丧偶者的总体死亡率风险最高（调整后的危险比（HR）：1.56，95%置信区间（CI）：1.35-1.81，P<0.001）和癌症特异性死亡率（调整后的 HR：1.33，95% CI：1.05-1.68，P=0.02）与其他未婚组相比，男性和女性均如此。此外，在 1:1 倾向评分匹配分析中，未婚状态仍然是 OS（HR 1.51，95% CI 1.19-1.90，P=0.001）和 CSS（HR 1.50，95% CI 1.10-2.05，P=0.01）的独立预后和危险因素。
婚姻状况是 G-NEN 的独立预后因素。同时，丧偶的 G-NEN 患者的死亡风险最高，其次是单身、已婚和离婚/分居的患者。
