Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy.
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, Medical University of Graz, Graz, Austria.
Urol Oncol. 2024 May;42(5):161.e17-161.e23. doi: 10.1016/j.urolonc.2024.01.022. Epub 2024 Feb 5.
Unmarried status has been associated with advanced stage at presentation and lower treatment dose intensification rates in several urological and non-urological malignancies. However, no previous investigators focused of the association of unmarried status with locally advanced stage (TN) at presentation and lower bi-/trimodal therapy rates in primary urethral carcinoma (PUC) patients. To address these knowledge gaps, we relied on the Surveillance, Epidemiology, and End Results (SEER) database.
Within the SEER database 2000 to 2020, all non-metastatic PUC patients were identified. Logistic regression models (LRMs) tested for differences in stage at presentation and treatment modality in the overall cohort and then in a sex-specific fashion, according to marital status (married vs unmarried).
Of all 1,430 non-metastatic PUC patients, 1,004 (70%) were male vs 426 (30%) were female. Of 1,004 male PUC patients, 272 (27%) were unmarried. Of all 426 female PUC patients, 239 (56%) were unmarried. In multivariable LRMs predicting TN, unmarried status was independently associated with an increased risk of locally advanced stage at presentation in the overall cohort (odds ratio [OR]:1.31; P = 0.03) and in female patients (OR:1.62; P = 0.02), but not in male PUC patients (P = 0.6). In multivariable LRMs predicting bi-/trimodal therapy, unmarried status was an independent predictor of lower bi-/trimodal therapy rates in the overall cohort (OR:0.73; P = 0.02) and in male patients (OR:0.60; P = 0.007), but not in female PUC patients (P = 0.6).
Unmarried female PUC patients more likely harbored locally advanced stage at presentation. Conversely, unmarried male PUC patients are less likely to benefit from bi-/trimodal therapy.
在一些泌尿科和非泌尿科恶性肿瘤中，未婚状态与就诊时的晚期阶段和较低的治疗剂量强化率有关。然而，以前没有研究人员关注未婚状态与原发性尿道癌 (PUC) 患者就诊时局部晚期 (TN) 阶段和较低的双/三模式治疗率之间的关系。为了解决这些知识空白，我们依赖于监测、流行病学和最终结果 (SEER) 数据库。
在 SEER 数据库 2000 年至 2020 年期间，确定了所有非转移性 PUC 患者。逻辑回归模型 (LRM) 测试了根据婚姻状况（已婚与未婚），在总体队列中以及在性别特异性方面，在就诊时的阶段和治疗方式上的差异。
在所有 1430 名非转移性 PUC 患者中，1004 名（70%）为男性，426 名（30%）为女性。在 1004 名男性 PUC 患者中，272 名（27%）未婚。在所有 426 名女性 PUC 患者中，239 名（56%）未婚。在多变量 LRM 预测 TN 中，未婚状态与总体队列中局部晚期就诊时的风险增加独立相关（优势比 [OR]：1.31；P = 0.03）和女性患者（OR：1.62；P = 0.02），但在男性 PUC 患者中则不然（P = 0.6）。在多变量 LRM 预测双/三模式治疗中，未婚状态是总体队列中双/三模式治疗率较低的独立预测因素（OR：0.73；P = 0.02）和男性患者（OR：0.60；P = 0.007），但在女性 PUC 患者中则不然（P = 0.6）。
未婚的女性 PUC 患者更有可能处于就诊时的局部晚期阶段。相反，未婚的男性 PUC 患者不太可能从双/三模式治疗中受益。
