Zheng Zhong Qiang, Sun Xuan Zi
Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Department of Radiation Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Gastroenterology Res. 2023 Dec;16(6):307-317. doi: 10.14740/gr1670. Epub 2023 Dec 9.
The impact of marital status on the prognosis of patients with Siewert type II adenocarcinoma of the esophagogatric junction (AEG) remained unclear. This study aimed to investigate the associations of marital status with cancer-specific death risk and cardiovascular death risk in Siewert type II AEG patients.
Data for Siewert type II AEG patients were obtained from the Surveillance, Epidemiology, and End Results database from 2010 to 2015. A 1:1 propensity score matching (PSM) was applied to reduce inter-group bias between the married and unmarried groups. Kaplan-Meier analysis, a competing risk model and the Fine-Gray multivariable regression model were used to identify the prognostic value of marital status.
In total, 1,623 subjects were included. After PSM, according to Fine-Gray multivariable regression analysis, there was no significant difference in the cumulative cancer-specific death rate between the married and the unmarried groups (hazard ratio (HR): 1.160, 95% confidence interval (CI): 0.994 - 1.354, P = 0.060). Patients in unmarried group had a higher cardiovascular death rate than patients in married group (HR: 3.066, 95% CI: 1.372 - 6.850, P = 0.006).
Our study demonstrates that unmarried Siewert type II AEG patients are associated with higher cardiovascular death risk but not cancer-specific death risk compared with married patients.
婚姻状况对食管胃交界部(AEG)Siewert II型腺癌患者预后的影响尚不清楚。本研究旨在探讨婚姻状况与Siewert II型AEG患者癌症特异性死亡风险和心血管死亡风险之间的关联。
获取2010年至2015年监测、流行病学和最终结果数据库中Siewert II型AEG患者的数据。采用1:1倾向评分匹配(PSM)以减少已婚组和未婚组之间的组间偏差。使用Kaplan-Meier分析、竞争风险模型和Fine-Gray多变量回归模型来确定婚姻状况的预后价值。
共纳入1623名受试者。PSM后,根据Fine-Gray多变量回归分析,已婚组和未婚组的累积癌症特异性死亡率无显著差异(风险比(HR):1.160,95%置信区间(CI):0.994 - 1.354,P = 0.060)。未婚组患者的心血管死亡率高于已婚组患者(HR:3.066,95%CI:1.372 - 6.850,P = 0.006)。
我们的研究表明,与已婚的Siewert II型AEG患者相比,未婚患者的心血管死亡风险更高,但癌症特异性死亡风险并无差异。