Marriage and mortality in bladder carcinoma
Marriage and mortality in bladder carcinoma
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DOI：
10.1002/cncr.21295
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发表时间：
2005-09-15
期刊：
影响因子：
6.2
通讯作者：
Litwin, MS
中科院分区：
文献类型：
--
作者：
Gore, JL;Kwan, L;Litwin, MS
背景。对于患有乳腺癌和前列腺癌等多种慢性病的患者来说，结婚可以显着提高生存率。作者试图确定婚姻状况是否与接受膀胱癌根治性膀胱切除术的患者的生存率相关。方法。作者从监测、流行病学和最终结果公共数据库中确定了 7262 名因膀胱移行细胞癌接受根治性膀胱切除术的受试者。他们使用 Kaplan-Meier 估计和 Cox 比例风险模型进行生存分析。作者创建了多变量模型来评估婚姻状况与生存之间的独立关联。控制病理分期、淋巴结状态、年龄、种族/民族和性别。结果。已婚受试者年龄较大，通常是男性、白人，诊断时处于早期疾病阶段。已婚受试者的生存率明显高于单身或丧偶受试者（P < 0.001），已婚受试者比分居/离婚受试者有更好的生存趋势（P = 0.20）。多变量模型显示，与单一受试者相比，已婚受试者的生存率更高，与诊断时的年龄、性别、种族/民族、疾病分期和淋巴结状态无关（P < 0.001）。结论。婚姻与膀胱癌患者生存率的提高相关，与已知影响该人群死亡率的其他因素无关。尽管这种生存优势的机制尚不清楚，但可能性包括癌症筛查、危险行为和获得医疗护理的差异。心理社会因素与身体免疫功能之间的相互作用可能进一步解释该人群的生存差异。
BACKGROUND. Being married confers significant benefits in survival for patients with a variety of chronic conditions including breast and prostate carcinoma. The authors attempted to determine whether marital status is associated with survival in patients undergoing radical cystectomy for bladder carcinoma.METHODS. The authors identified 7262 subjects from the Surveillance, Epidemiology, and End Results public-use database who underwent radical cystectomy for transitional cell carcinoma of the bladder. They performed survival analyses using Kaplan-Meier estimates and Cox proportional hazards models. The authors created multivariate models to evaluate the independent association between marital status and survival,. controlling for pathologic stage, lymph node status, age, race/ethnicity, and gender.RESULTS. Married subjects were older and more often male, white, and had earlier disease stage at diagnosis. Married subjects had significantly better survival than did single or widowed subjects (P < 0.001), and married subjects revealed a trend toward better survival than separated/divorced subjects (P = 0.20). Multivariate modeling revealed that compared with single subjects, those who were married had better Survival, independent of age at the time of diagnosis, gender, race/ ethnicity, disease stage, and lymph node status (P < 0.001).CONCLUSIONS. Marriage was associated with improved survival in patients with bladder carcinoma, independent of other factors known to influence mortality in this population. Although the mechanisms underlying this survival advantage are unknown, possibilities include differences in cancer screening, risk behaviors, and access to medical care. The interaction between psychosocial factors and the body's immune function may further explain the differential survival in this cohort.