Division of Urologic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, PR China.
Can J Urol. 2022 Feb;29(1):10992-11002.
To determine whether marital status combined with race serve as prognostic factors for survival in localized prostate cancer.
Patients with localized prostate cancer were retrospectively extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Chi-square test was used to investigate the association between marital status combined with race and other variables. Gray's test was used to compare the cumulative incidence function of different variables. Multivariable analysis was conducted to assess prognostic factors after adjusting for other variables.
A total of 207,219 patients with localized prostate cancer from the SEER database from 2010 to 2016 were eligible. We found that black or single patients had the highest risk of mortality (p < 0.001). When marital status and race were combined, single black patients had the worst prognosis after adjusting for other variables (hazard ratio = 1.93, 95% confidence interval: 1.58-2.35; p < 0.001). Married status had a prognostic advantage in all races. In the same marital groups, whites and Asians had lower risk of prostate cancer-specific mortality and other-cause mortality than blacks with married and single status (p < 0.001).
Marital status and race serve as prognostic factors for localized prostate cancer. Blacks or single individuals had higher risk of mortality when considered independently, and single black patients had the worst prognosis. Furthermore, married status was an advantage in the same race group, and whites and Asians had lower risk than blacks with married and single status. Accordingly, the interaction between race and marital status on prostate cancer prognosis in clinical practice should be assessed carefully.
确定婚姻状况与种族相结合是否为局部前列腺癌生存的预后因素。
从监测、流行病学和最终结果（SEER）数据库中回顾性提取局部前列腺癌患者。卡方检验用于研究婚姻状况与种族等变量之间的关系。灰色检验用于比较不同变量的累积发生率函数。多变量分析用于调整其他变量后评估预后因素。
共有 207219 名来自 2010 年至 2016 年 SEER 数据库的局部前列腺癌患者符合条件。我们发现黑人或单身患者的死亡率最高（p<0.001）。当婚姻状况和种族相结合时，在调整其他变量后，单身黑人患者的预后最差（风险比=1.93，95%置信区间：1.58-2.35；p<0.001）。已婚状态在所有种族中都有预后优势。在相同的婚姻群体中，与已婚和单身的黑人相比，白人亚洲人患前列腺癌特异性死亡率和其他原因死亡率的风险较低（p<0.001）。
婚姻状况和种族是局部前列腺癌的预后因素。黑人或单身个体在独立考虑时死亡率较高，而单身黑人患者的预后最差。此外，在同一种族群体中，已婚状态是一个优势，而白人和亚洲人患前列腺癌的风险低于已婚和单身的黑人。因此，在临床实践中，种族和婚姻状况对前列腺癌预后的相互作用应仔细评估。
