Qing Maofeng, Peng Jiakuan, Shang Qianhui, Xu Hao, Chen Qianming
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Front Surg. 2022 Apr 11;9:880893. doi: 10.3389/fsurg.2022.880893. eCollection 2022.
Marital status has been associated with the outcomes in several types of cancer, but less is known about upper digestive tract tumors (UDTTs). The study aims to explore the effect of marital status on the survival outcomes of UDTT.
We collected patient cases of UDTT using the Surveillance, Epidemiology, and End Results (SEER) database between 1975 and 2016. The univariate analyses of overall survival (OS) and cancer-specific survival (CSS) were performed using the Kaplan-Meier method. The multivariate survival analyses were performed using Cox proportional hazard model.
A total of 282,189 patients were included, with 56.42, 16.30, 13.33, and 13.95% of patients married, never married, divorced or separated, and widowed, respectively. The significant differences were observed among married, never-married, divorced or separated, and widowed patients with regard to the year of diagnosis, sex, age, race, pathological type, anatomical site, the number of primary tumor, grade, rate of surgery performed, radiotherapy, chemotherapy ( < 0.001). The proportions of patients with 3-year and 5-year OS were 54.22 and 48.02% in the married group, 46.96 and 41.12% in the never-married group, 44.24 and 38.06% in the divorced or separated group, 34.59 and 27.57% in the widowed group, respectively ( < 0.001); the proportions of patients with 3-year and 5-year CSS were 70.76 and 68.13% in the married group, 62.44 and 59,93% in the never-married group, 63.13 and 60.53% in the divorced or separated group, 62.11 and 58.89% in the widowed group, respectively ( < 0.001); all these data indicated married patients exhibited favorable OS and CSS than never-married, divorced or separated, and widowed patients. Men in the married group showed better OS (, 1.16; 95%CI: 1.11-1.22) and CSS (, 0.96; 95%CI: 0.92-1.23) than those in the never-married group.
This study reveals that marital status is an independent prognostic factor for OS and CSS of patients with UDTT. Married male patients with UDTT trend to have a better prognosis.
婚姻状况与多种癌症的预后相关，但关于上消化道肿瘤（UDTT）的相关情况了解较少。本研究旨在探讨婚姻状况对上消化道肿瘤患者生存结局的影响。
我们使用监测、流行病学和最终结果（SEER）数据库收集了1975年至2016年间的上消化道肿瘤患者病例。采用Kaplan-Meier方法对总生存期（OS）和癌症特异性生存期（CSS）进行单因素分析。使用Cox比例风险模型进行多因素生存分析。
共纳入282,189例患者，其中已婚、未婚、离异或分居、丧偶患者分别占56.42%、16.30%、13.33%和13.95%。已婚、未婚、离异或分居以及丧偶患者在诊断年份、性别、年龄、种族、病理类型、解剖部位、原发肿瘤数量、分级、手术率、放疗、化疗方面存在显著差异（<0.001）。已婚组3年和5年总生存率分别为54.22%和48.02%，未婚组为46.96%和41.12%，离异或分居组为44.24%和38.06%，丧偶组为34.59%和27.57%（<0.001）；已婚组3年和5年癌症特异性生存率分别为70.76%和68.13%，未婚组为62.44%和59.93%，离异或分居组为63.13%和60.53%，丧偶组为62.11%和58.89%（<0.001）；所有这些数据表明已婚患者的总生存期和癌症特异性生存期均优于未婚、离异或分居以及丧偶患者。已婚组男性的总生存期（比值比，1.16；95%置信区间：1.11 - 1.22）和癌症特异性生存期（比值比，0.96；95%置信区间：0.92 - 1.23）均优于未婚组男性。
本研究表明婚姻状况是上消化道肿瘤患者总生存期和癌症特异性生存期的独立预后因素。已婚的上消化道肿瘤男性患者预后往往更好。
