Guo Zhenlang, Gu Chiming, Li Siyi, Gan Shu, Li Yuan, Xiang Songtao, Gong Leiliang, Wang Shusheng
Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Department of mechanical engineering, National University of Singapore, Kent Ridge, Singapore.
Urol J. 2020 Nov 23;18(4):371-379. doi: 10.22037/uj.v16i7.6197.
The impact of marital status on the prognosis amongst patients diagnosed with prostate cancer remains controversial. Thus, a meta-analysis was performed to determine whether marital status can influence the prognosis in patients with prostate cancer.
Literature search of the MEDLINE, PsycINFO, Embase and Cochrane Library databases was conducted to identify eligible studies published before April 2020. Multivariate adjusted risk estimates and corresponding 95% confidence intervals (CIs) were extracted and calculated using the random effects model.
A total of 11 observational studies comprising 1,457,799 patients diagnosed with prostate cancer were identified. Results indicated that unmarried status (separated, divorced, widowed or never married) was associated with an increased risk of all-cause mortality (hazard ratio, HR = 1.39, 95% CI: 1.30-1.50; P < .001; I2 = 92.2%) compared with married status, especially for divorced and never-married patients. Similarly, being unmarried had an elevated risk of cancer-specific mortality (HR = 1.29, 95% CI: 1.17-1.41; P < .001; I2 = 82.5%) in patients with prostate cancer. A significant difference was also observed between unmarried status and shorter overall survival (HR = 1.37, 95% CI: 1.20-1.56; P < .001; I2 = 94.5%).
Results demonstrated that unmarried status is associated with a worse prognosis regarding mortality and survival in patients diagnosed with prostate cancer, particularly in divorced and never-married patients. Hence, further research should explore the potential mechanisms which can benefit the development of novel, more personalised management methods for unmarried patients with prostate cancer.
婚姻状况对前列腺癌患者预后的影响仍存在争议。因此，进行了一项荟萃分析，以确定婚姻状况是否会影响前列腺癌患者的预后。
对MEDLINE、PsycINFO、Embase和Cochrane图书馆数据库进行文献检索，以识别2020年4月之前发表的符合条件的研究。使用随机效应模型提取并计算多变量调整后的风险估计值和相应的95%置信区间（CIs）。
共确定了11项观察性研究，涉及1,457,799例诊断为前列腺癌的患者。结果表明，与已婚状态相比，未婚状态（分居、离婚、丧偶或从未结婚）与全因死亡率风险增加相关（风险比，HR = 1.39，95% CI：1.30 - 1.50；P <.001；I2 = 92.2%），尤其是离婚和从未结婚的患者。同样，未婚状态的前列腺癌患者癌症特异性死亡率风险也升高（HR = 1.29，95% CI：1.17 - 1.41；P <.001；I2 = 82.5%）。未婚状态与较短的总生存期之间也观察到显著差异（HR = 1.37，95% CI：1.20 - 1.56；P <.001；I2 = 94.5%）。
结果表明，未婚状态与诊断为前列腺癌患者的死亡率和生存期预后较差相关，特别是在离婚和从未结婚的患者中。因此，进一步的研究应探索潜在机制，这可能有利于为未婚前列腺癌患者开发新的、更个性化的管理方法。
