Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, P.R. China.
BMC Womens Health. 2024 Jan 28;24(1):75. doi: 10.1186/s12905-024-02907-5.
Cervical cancer is the fourth most common malignant tumor troubling women worldwide. Whether marital status affects the prognosis of cervical cancer is still unclear. Here, we investigate the prognostic value of marital status in patients with cervical cancer based on the seer database.
MATERIAL/METHODS: The demographic and clinical data of patients with cervical cancer were extracted from the Surveillance, Epidemiology, and End Results (SEER) database from 1975 to 2017. Patients were divided into two groups (married and unmarried) according to marital status, and then the clinical characteristics of each group were compared using the chi-square test. Propensity score matching (PSM) was used to reduce differences in baseline characteristics. The overall survival (OS) and cervical cancer-specific survival (CCSS) were assessed by the Kaplan-Meier method, univariate and multivariate Cox regression models, and stratified analysis. Moreover, univariate and multivariate competing risk regression models were performed to calculate hazard ratios (HR) of death risk.
A total of 21,148 patients were included in this study, including 10,603 married patients and 10,545 unmarried patients. Married patients had better OS(P < 0.05) and CCSS (P < 0.05) compared to unmarried patients, and marital status was an independent prognostic factor for both OS (HR: 0.830, 95% CI: 0.798-0.862) and CCSS (HR: 0.892, 95% CI: 0.850-0.937). Moreover, after eliminating the competing risk, married patients (CCSD: HR:0.723, 95% CI: 0.683-0.765, P < 0.001) had a significantly decreased risk of death compared to unmarried patients. In stratified analysis, the married patients showed better OS and CCSS than the unmarried patients diagnosed in 1975-2000 and 2001-2017.
Being married was associated with a favorable prognosis of cervical cancer, and marital status was an independent prognostic factor for cervical cancer.
宫颈癌是全球第四大常见的困扰女性的恶性肿瘤。婚姻状况是否影响宫颈癌的预后尚不清楚。在这里，我们根据 SEER 数据库研究婚姻状况对宫颈癌患者预后的影响。
材料/方法：从 1975 年至 2017 年，从监测、流行病学和最终结果（SEER）数据库中提取宫颈癌患者的人口统计学和临床数据。根据婚姻状况将患者分为两组（已婚和未婚），然后使用卡方检验比较每组的临床特征。采用倾向评分匹配（PSM）减少基线特征差异。采用 Kaplan-Meier 法、单因素和多因素 Cox 回归模型以及分层分析评估总生存率（OS）和宫颈癌特异性生存率（CCSS）。此外，还进行了单因素和多因素竞争风险回归模型以计算死亡风险的危险比（HR）。
本研究共纳入 21148 例患者，包括 10603 例已婚患者和 10545 例未婚患者。与未婚患者相比，已婚患者的 OS（P<0.05）和 CCSS（P<0.05）更好，婚姻状况是 OS（HR：0.830，95%CI：0.798-0.862）和 CCSS（HR：0.892，95%CI：0.850-0.937）的独立预后因素。此外，在消除竞争风险后，与未婚患者相比，已婚患者（CCSD：HR：0.723，95%CI：0.683-0.765，P<0.001）的死亡风险显著降低。在分层分析中，与未婚患者相比，1975-2000 年和 2001-2017 年诊断的已婚患者的 OS 和 CCSS 更好。
已婚与宫颈癌的良好预后相关，婚姻状况是宫颈癌的独立预后因素。
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