Huang Xiaoxia, Tian Leilei, Li Chuang, Liu Jinling, Shi Rui, Lin Fang, Luo Yi
Operating Room, West China Hospital, West China School of Nursing, Sichuan University, Chengdu, China.
Department of Orthopedics and Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, China.
Transl Cancer Res. 2024 Nov 30;13(11):5898-5908. doi: 10.21037/tcr-24-1215. Epub 2024 Nov 25.
Previous studies have demonstrated a significant impact of marital status on the prognosis of various cancers; however, its specific influence on the prognosis of primary bone cancer remains insufficiently investigated. In this study, we aimed to investigate the survival differences between male and female in patients diagnosed with primary bone cancer.
Surveillance, Epidemiology, and End Results (SEER) database was utilized to identify suitable patients. Patients were categorized into married and unmarried groups, with a 1:1 propensity score matching (PSM) method used to balance baseline characteristics between the two groups. Kaplan-Meier curves and Log-rank tests were then employed to ascertain differences in overall survival (OS) and cancer-specific survival (CSS) between the groups, followed by gender-based subgroup analyses. A multivariate Cox regression was finally conducted to adjust for the effects of covariates.
A total of 8,208 patients were included in this study, comprising 4,650 married and 3,558 unmarried individuals. Significant baseline characteristic differences were observed between the two groups before PSM. After PSM, 3,138 patients from each group were included, with balance maintained in all considered baseline characteristics. Before PSM, married patients had better OS [hazard ratio (HR) =0.93, 95% confidence interval (CI): 0.87-0.99, P=0.047] compared to unmarried patients, but no significant difference in CSS (HR =0.95, 95% CI: 0.88-1.03, P=0.21). Following PSM, married patients exhibited significantly better OS (HR =0.85, 95% CI: 0.79-0.92, P<0.001) and CSS (HR =0.92, 95% CI: 0.84-0.99, P=0.045) than unmarried patients. However, in subgroup analyses, the survival benefit attributed to marriage was observed only in females, not in males. In Cox regression, marriage was identified as an independent protective factor for OS (HR =0.86, 95% CI: 0.79-0.93, P<0.001) and CSS (HR =0.91, 95% CI: 0.82-0.97, P=0.04).
In patients with primary malignant bone cancer, marriage is a protective factor for survival, but this effect appears to be limited to females.
先前的研究已证明婚姻状况对各种癌症的预后有显著影响；然而，其对原发性骨癌预后的具体影响仍未得到充分研究。在本研究中，我们旨在调查诊断为原发性骨癌的患者中男性和女性的生存差异。
利用监测、流行病学和最终结果（SEER）数据库来识别合适的患者。患者被分为已婚和未婚两组，采用1:1倾向评分匹配（PSM）方法来平衡两组之间的基线特征。然后使用Kaplan-Meier曲线和对数秩检验来确定两组之间总生存期（OS）和癌症特异性生存期（CSS）的差异，随后进行基于性别的亚组分析。最后进行多变量Cox回归以调整协变量的影响。
本研究共纳入8208例患者，其中已婚4650例，未婚3558例。在PSM之前，两组之间观察到显著的基线特征差异。PSM之后，每组纳入3138例患者，所有考虑的基线特征均保持平衡。在PSM之前，已婚患者与未婚患者相比，OS更好[风险比（HR）=0.93，95%置信区间（CI）：0.87-0.99，P=0.047]，但CSS无显著差异（HR =0.95，95%CI：0.88-1.03，P=0.21）。PSM之后，已婚患者的OS（HR =0.85，95%CI：0.79-0.92，P<0.001）和CSS（HR =0.92，95%CI：0.84-0.99，P=0.045）均显著优于未婚患者。然而，在亚组分析中，仅在女性中观察到婚姻带来的生存益处，在男性中未观察到。在Cox回归中，婚姻被确定为OS（HR =0.86，95%CI：0.79-0.93，P<0.001）和CSS（HR =0.91，95%CI：0.82-0.97，P=0.04）的独立保护因素。
在原发性恶性骨癌患者中，婚姻是生存的保护因素，但这种影响似乎仅限于女性。
