Effect of marital status on the survival of patients with hepatocellular carcinoma treated with surgical resection: an analysis of 13,408 patients in the surveillance, epidemiology, and end results (SEER) database.
Effect of marital status on the survival of patients with hepatocellular carcinoma treated with surgical resection: an analysis of 13,408 patients in the surveillance, epidemiology, and end results (SEER) database.
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DOI：
10.18632/oncotarget.12722
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发表时间：
2016-11-29
期刊：
影响因子：
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通讯作者：
Jiang GQ
中科院分区：
文献类型：
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作者：
Wu C;Chen P;Qian JJ;Jin SJ;Yao J;Wang XD;Bai DS;Jiang GQ
婚姻状况已被报道为各种癌症生存的一个独立预后因素，但很少研究肝细胞癌（HCC）手术切除治疗。我们回顾性调查了基于人群的监测、流行病学和最终结果（SEER）数据，并确定了1998年至2013年期间13，408例手术治疗的HCC病例。根据婚姻状况，将患者分类为“已婚”、“未婚”、“丧偶”或“离婚/分居”。获得5年HCC病因特异性生存（HCSS）数据，并使用Kaplan-Meier方法和多变量考克斯回归模型来确定婚姻状况是否也是HCC生存的独立预后因素。丧偶组患者中女性比例更高，老年（>60岁）患者比例更高，最近一年（2008-2013年）诊断频率更高，TNM I/II期肿瘤数量更多，局限性SEER分期患病率更高，组内比较均具有统计学意义（P < 0.001）。多因素生存分析显示婚姻状况是独立的预后因素（P < 0.001）。已婚患者的5年HCSS评分高于未婚患者（46.7% vs 37.8%）（P < 0.001）;相反，丧偶患者的5年HCSS评分低于所有其他患者，总体而言，在每个SEER分期，以及不同的肿瘤大小。婚姻状况是影响手术切除HCC患者生存率的重要预后因素。与其他群体相比，丧偶患者的死亡风险最高。
Marital status has been reported as an independent prognostic factor for survival in various cancers, but it has been rarely studied in hepatocellular carcinoma (HCC) treated by surgical resection. We retrospectively investigated Surveillance, Epidemiology, and End Results (SEER) population-based data and identified 13,408 cases of HCC with surgical treatment between 1998 and 2013. The patients were categorized according to marital status, as “married,” “never married,” “widowed,” or “divorced/separated.” The 5-year HCC cause-specific survival (HCSS) data were obtained, and Kaplan–Meier methods and multivariate Cox regression models were used to ascertain whether marital status is also an independent prognostic factor for survival in HCC. Patients in the widowed group had the higher proportion of women, a greater proportion of older (>60 years) patients, more frequency in latest year of diagnosis (2008-2013), a greater number of tumors at TNM stage I/II, and more prevalence at localized SEER Stage, all of which were statistically significant within-group comparisons (P < 0.001). Marital status was demonstrated to be an independent prognostic factor by multivariate survival analysis (P < 0.001). Married patients had better 5-year HCSS than did unmarried patients (46.7% vs 37.8%) (P < 0.001); conversely, widowed patients had lowest HCSS compared with all other patients, overall, at each SEER stage, and for different tumor sizes. Marital status is an important prognostic factor for survival in patients with HCC treated with surgical resection. Widowed patients have the highest risk of death compared with other groups.