Marital status independently predicts prostate cancer survival in men who underwent radical prostatectomy: An analysis of 95,846 individuals.
Marital status independently predicts prostate cancer survival in men who underwent radical prostatectomy: An analysis of 95,846 individuals.
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DOI：
10.3892/ol.2018.7964
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发表时间：
2018-04
期刊：
影响因子：
2.9
通讯作者：
Ding XF
中科院分区：
文献类型：
--
作者：
Huang TB;Zhou GC;Dong CP;Wang LP;Luan Y;Ye JT;Gu X;Yao XD;Zheng JH;Ding XF
婚姻状况是几种类型癌症生存的独立预后因素，但尚未在前列腺癌（PCa）中进行充分研究。在2004年至2009年期间，在18个监测、流行病学和最终结果登记中心，共有95，846名诊断为PCa的男性接受了根治性前列腺切除术（RP）治疗。使用Kaplan-Meier估计生成生存曲线，并使用对数秩检验评估生存差异。考克斯回归模型被用来评估婚姻状况对生存结果的影响。结果表明，已婚男性的8年癌症原因特异性生存率（CSS）高于未婚个体。进一步分析显示，离婚/分居男性在诊断时具有较高比例的高Gleason评分（GS）PCa [风险比（HR），1.12; P=0.007]，这些患者的生存结局最差，与年龄、种族、分级、分期和序列号无关[HR，1.61; 95%置信区间（CI），1.34-1.93]。有趣的是，离婚/分居男性的CSS随着GS的增加而降低（GS≤6：HR，2.5; GS=7：HR，1.71; GS≥8：HR，1.50;所有P<0.05）。除此之外，从未结婚（HR，1.20）或丧偶（HR，1.13）的人与已婚组相比，CSS没有显著差异。本研究的结果支持这一假设，即婚姻状况是一个独立的预后因素与前列腺癌的男性谁经历RP。结果表明，与其他组相比，离婚或分居的PCa男性的死亡率显着更高。进一步了解婚姻状况，心理社会因素和生存结果之间的潜在关联可能有助于开发新的，更有效的方法来治疗不同群体的PCa患者。
Marital status is an independent prognostic factor for survival in several types of cancer, but has not been fully studied in prostate cancer (PCa). A total of 95,846 men diagnosed with PCa were treated with radical prostatectomy (RP) between 2004 and 2009 within 18 Surveillance, Epidemiology and End Results registries. Survival curves were generated using Kaplan-Meier estimates and differences in survival were assessed using the log-rank test. Cox regression models were used to assess the impact of marital status on survival outcomes. The results demonstrated that the 8-year cancer-cause specific survival (CSS) rate of married men was higher than unmarried individuals. Further analyses revealed that divorced/separated men had a higher proportion of high Gleason scores (GS) PCa at diagnosis [hazard ratio (HR), 1.12; P=0.007] and those patients had the worst survival outcomes independent of age, ethnicity, grade, stage and sequence number [HR, 1.61; 95% confidence interval (CI), 1.34–1.93]. Interestingly, it was observed that CSS among divorced/separated men decreased as the GS increased (GS≤6: HR, 2.5; GS=7: HR, 1.71; GS≥8: HR, 1.50; all P<0.05). Apart from that, no significant differences in CSS were observed in those who had never been married (HR, 1.20) or were widowed (HR, 1.13) relative to the married group. The results of the present study support the hypothesis that marital status is an independent prognostic factor among men with PCa who underwent RP. It was demonstrated that the mortality rates of divorced or separated men with PCa were significantly greater compared with the other groups. A further understanding of the potential associations among marital status, psychosocial factors and survival outcomes may help in developing novel, more effective methods of treating different groups of patients with PCa.
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