Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P. R. China.
Department of Neurosurgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China.
World Neurosurg. 2021 Aug;152:e302-e312. doi: 10.1016/j.wneu.2021.05.091. Epub 2021 May 29.
To examine the impact of marital status on the mortality of patients with primary malignant brain tumors excluding bias from basic characteristics and treatment.
We used the Surveillance, Epidemiology, and End Results program to identify 81,277 patients diagnosed from 2000 through 2016 with the most common primary malignant brain tumors, including glioma, ependymoma, and medulloblastoma. To avoid bias, we used the propensity score matching method to match 44,854 patients with complete clinical and follow-up information. Then, we used Cox regression and Kaplan-Meier survival analysis to investigate the impact of marital status on cancer patient mortality.
Married patients were more likely to receive surgery and adjuvant chemo- or radiotherapy than single and divorced, separated, and widowed (DSW) patients (all P < 0.001). Married patients with high grade glioma were more likely to survive longer and less likely to die of their malignance compared with single (adjusted odds ratio [OR] 1.120; 95% confidence interval [CI], 1.069 to 1.174; P < 0.001; OR 1.078; 95% CI, 1.025 to 1.133; P = 0.003; respectively), and DSW patients (OR 1.117; 95% CI, 1.074 to 1.161; P <0.001; OR 1.090; 95% CI, 1.046 to 1.136; P<0.001; respectively) (all adjusted to the married group). Similar results were identified in patients with low-grade glioma but not ependymoma and medulloblastoma.
Even after adjusting for known confounders, married patients with high-grade glioma and low-grade glioma are at higher possibility to have a better outcome. This study highlights the potential significance that intimate support from spouse can improve glioma patient survival.
研究婚姻状况对原发性恶性脑肿瘤患者死亡率的影响，排除基本特征和治疗因素的偏倚。
我们利用监测、流行病学和最终结果（SEER）计划，从 2000 年至 2016 年，确定了 81277 例最常见的原发性恶性脑肿瘤患者，包括胶质瘤、室管膜瘤和髓母细胞瘤。为了避免偏倚，我们使用倾向评分匹配方法对 44854 例具有完整临床和随访信息的患者进行了匹配。然后，我们使用 Cox 回归和 Kaplan-Meier 生存分析来研究婚姻状况对癌症患者死亡率的影响。
与单身、离异、分居和丧偶（DSW）患者相比，已婚患者更有可能接受手术和辅助化疗或放疗（均 P < 0.001）。高级别胶质瘤的已婚患者存活时间更长，死于恶性肿瘤的可能性更小，与单身患者相比（调整后优势比 [OR] 1.120；95%置信区间 [CI]，1.069 至 1.174；P < 0.001；OR 1.078；95% CI，1.025 至 1.133；P=0.003），与 DSW 患者相比（OR 1.117；95% CI，1.074 至 1.161；P<0.001；OR 1.090；95% CI，1.046 至 1.136；P<0.001）。在低级别胶质瘤患者中也观察到了类似的结果，但在室管膜瘤和髓母细胞瘤患者中没有观察到。
即使在调整了已知混杂因素后，高级别和低级别胶质瘤的已婚患者也更有可能获得更好的结果。本研究强调了配偶的亲密支持可能改善胶质瘤患者生存的潜在意义。
