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Xie C, Jiang R, Wang C, Lei X, Lu K, Luo H. Development and validation of a nomogram integrating marital status for 5-year overall survival of chondrosarcoma: a population-based study. Discov Oncol 2024; 15:169. [PMID: 38753185 PMCID: PMC11098994 DOI: 10.1007/s12672-024-01020-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 05/07/2024] [Indexed: 05/19/2024] Open
Abstract
OBJECTIVES The objective of this study was to evaluate the influence of marital status on overall survival (OS) and develop a nomogram for predicting 5-year OS in chondrosarcoma (CHS) patients. METHODS We utilized the Surveillance, Epidemiology, and End Results (SEER) database to identify CHS patients diagnosed between 2010 and 2018. Survival rates were calculated using Kaplan-Meier analysis. Prognostic factors were identified through univariate and multivariate analyses. An independent cohort was used for external validation of the nomogram. Performance evaluation of the nomogram was conducted using Harrell's concordance index (C-index), calibration plot, and decision curve analysis (DCA). RESULTS In the SEER cohort, Kaplan-Meier analysis showed significant differences in OS among CHS patients with different marital statuses (P < 0.001), with widowed patients having the lowest OS. In terms of gender, there were significant survival differences based on marital status in females (P < 0.001), but not in males (P = 0.067). The OS of married and single females is significantly higher than that of married (P < 0.001) and single male (P = 0.006), respectively. Kaplan-Meier curves showed no significant difference in OS between groups stratified by either gender or marital status in the external cohort. Univariate and multivariate analyses confirmed that age at diagnosis, gender, marital status, tumor size, histological type, tumor grade, SEER stage, and surgery were independent prognostic factors for OS. The nomogram demonstrated high internal and external validation C-indexes of 0.818 and 0.88, respectively. Calibration plots, DCA curve, and Kaplan-Meier curve (P < 0.001) confirmed the excellent performance and clinical utility of the nomogram. CONCLUSIONS Marital status was an independent factor influencing OS in CHS patients, with widowed patients having the worst prognosis. The OS of both married and single females is significantly higher than that of their male counterparts. However, these findings require further validation in a large independent cohort. While the contribution of marital status on predicting OS appears modest, our nomogram accurately predicted 5-year OS and identified high-risk groups, providing a valuable tool for clinical decision-making.
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Affiliation(s)
- Chengxin Xie
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, 317099, China
- Shandong First Medical University, Jinan, 250021, China
| | - Ruiyuan Jiang
- Department of Graduate Student, Zhejiang University of Chinese Medicine, Hangzhou, 310000, China
- Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, 310022, China
| | - Chenglong Wang
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, 317099, China
| | - Xinhuan Lei
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, 317099, China
| | - Kaicheng Lu
- Department of Graduate Student, Faculty of Chinese Medicine Science, Guangxi University of Chinese Medicine, Nanning, 530022, China
| | - Hua Luo
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, 317099, China.
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Siech C, Morra S, Scheipner L, Baudo A, Jannello LMI, de Angelis M, Goyal JA, Tian Z, Saad F, Shariat SF, Longo N, Carmignani L, de Cobelli O, Ahyai S, Briganti A, Mandel P, Kluth LA, Chun FKH, Karakiewicz PI. Married Status Affects Rates of Treatment and Mortality in Male and Female Renal Cell Carcinoma Patients Across all Stages. Clin Genitourin Cancer 2024; 22:593-598. [PMID: 38369387 DOI: 10.1016/j.clgc.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/20/2024]
Abstract
INTRODUCTION The association between treatment rates and cancer specific mortality (CSM) according to married status in male and female clear cell renal cell carcinoma (ccRCC) patients across all stages is unknown. PATIENT AND METHODS Using the Surveillance, Epidemiology, and End Results database (2004-2020), ccRCC patients were stratified according to married status (married vs. unmarried). Logistic regression models addressed treatment rates; Cox regression models addressed CSM rates. RESULTS Of 98,142 patients, 43,999 (72%) males and 20,287 (55%) females were married. In stage-specific analyses, married status independently predicted higher nephrectomy rates in males and females (all P ≤ .03). In stage IV, married status predicted higher systemic therapy rate in males (P < .001), but not in females. In survival analyses, married males exhibited lower CSM rates relative to unmarried males (all P ≤ .02). Conversely, married females exhibited lower CSM rates only in stages I and III (all P ≤ .02), but not in stages II and IV. In subgroup analyses of T1aN0M0 patients, married status was associated with higher partial nephrectomy rates in both males and females (all P ≤ .005). CONCLUSION In ccRCC, married status invariably predicts higher rates of guideline recommended surgical management (nephrectomy and partial nephrectomy). Moreover, even after adjustment for treatment type, married status independently predicted lower CSM rates in males across all stages. However, the effect of married status in females is only operational in stages I and III. Lack of association between married status in stages II and IV may potentially be explained by stronger association with treatment assignment which reduces the residual effect on survival.
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Affiliation(s)
- Carolin Siech
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Goethe University Frankfurt, University Hospital, Department of Urology, Frankfurt am Main, Germany.
| | - Simone Morra
- 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
| | - Lukas Scheipner
- 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
| | - Andrea Baudo
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, IRCCS Policlinico San Donato, Milan, Italy
| | - Letizia M I Jannello
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy; Università degli Studi di Milano, Milan, Italy
| | - Mario de Angelis
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Jordan A Goyal
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Zhe Tian
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Fred Saad
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
| | - Nicola Longo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Luca Carmignani
- Department of Urology, IRCCS Policlinico San Donato, Milan, Italy; Department of Urology, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy
| | - Ottavio de Cobelli
- Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy; Università degli Studi di Milano, Milan, Italy; Department of Oncology and Haemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Sascha Ahyai
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Alberto Briganti
- Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Philipp Mandel
- Goethe University Frankfurt, University Hospital, Department of Urology, Frankfurt am Main, Germany
| | - Luis A Kluth
- Goethe University Frankfurt, University Hospital, Department of Urology, Frankfurt am Main, Germany
| | - Felix K H Chun
- Goethe University Frankfurt, University Hospital, Department of Urology, Frankfurt am Main, Germany
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
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Hu S, Sun C, Chen M, Zhou J. Marital Status as an Independent Prognostic Factor in Patients with Glioblastoma: A Population-Based Study. World Neurosurg 2024; 182:e559-e569. [PMID: 38061540 DOI: 10.1016/j.wneu.2023.11.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND This study was aimed to investigate the effects of marital status on overall survival (OS) and cancer-specific survival (CSS) in patients with glioblastoma (GBM) and to develop nomograms for predicting prognosis in GBM patients. METHODS All patients were selected from the Surveillance, Epidemiology, and End Results cancer registry program. We used propensity score matching to balance the baseline characteristics of married and unmarried patients. The effects of marital status on OS and CSS were then assessed using Kaplan-Meier curves and Cox proportional hazard regression, and the magnitude of each factor was visualized in the form of forest maps. The impact of marriage on the survival of GBM patients was further explored by stratifying several demographic factors. Finally, the nomograms were constructed and verified based on Cox proportional risk regression model. RESULTS A total of 17,517 patients with GBM (11,818 married patients, 67.5%) were enrolled in the study cohort. After propensity score matching, there were 5699 patients in both the married and unmarried groups. Multivariate Cox regression analysis showed that both married and single patients had better OS (married: hazard ratio [HR] 0.824, 95% confidence interval [CI]: 0.788-0.862, P < 0.001; single: HR 0.764, 95% CI: 0.722-0.808, P < 0.001) and CSS (married: HR 0.833, 95% CI: 0.796-0.872, P < 0.001; single: HR 0.761, 95% CI: 0.718-0.806, P < 0.001) than divorced, separated, and widowed patients. CONCLUSIONS Marital status was an independent prognostic factor in patients with GBM. The nomograms constructed in this study could help medical professionals to provide personalized prognostic assessment and treatment decisions for patients with GBM.
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Affiliation(s)
- Shaobo Hu
- Department of Neurosurgery, The Affiliated Li Huili Hospital, Ningbo University, Ningbo, Zhejiang, China.
| | - Chengfeng Sun
- Department of Neurosurgery, The Affiliated Li Huili Hospital, Ningbo University, Ningbo, Zhejiang, China
| | - Maosong Chen
- Department of Neurosurgery, The Affiliated Li Huili Hospital, Ningbo University, Ningbo, Zhejiang, China
| | - Jiang Zhou
- Department of Neurosurgery, The Affiliated Li Huili Hospital, Ningbo University, Ningbo, Zhejiang, China
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Baudo A, Morra S, Scheipner L, Jannello LMI, de Angelis M, Siech C, Touma N, Goyal JA, Tian Z, Acquati P, Longo N, Ahyai S, de Cobelli O, Briganti A, Chun FKH, Saad F, Shariat SF, Carmignani L, Karakiewicz PI. The effect of married status on cancer-specific mortality in nonmetastatic pelvic liposarcoma patients according to sex. World J Surg 2024; 48:97-103. [PMID: 38686806 DOI: 10.1002/wjs.12040] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/26/2023] [Indexed: 05/02/2024]
Abstract
BACKGROUND In nonmetastatic pelvic liposarcoma patients, it is unknown whether married status is associated with better cancer-control outcome defined as cancer-specific mortality (CSM). We addressed this knowledge gap and hypothesized that married status is associated with lower CSM rates in both male and female patients. METHODS Within the Surveillance, Epidemiology, and End Results database (2000-2020), nonmetastatic pelvic liposarcoma patients were identified. Kaplan-Meier plots and univariable and multivariable Cox regression models (CRMs) predicting CSM according to marital status were used in the overall cohort and in male and female subgroups. RESULTS Of 1078 liposarcoma patients, 764 (71%) were male and 314 (29%) female. Of 764 male patients, 542 (71%) were married. Conversely, of 314 female patients, 192 (61%) were married. In the overall cohort, 5-year cancer-specific mortality-free survival (CSM-FS) rates were 89% for married versus 83% for unmarried patients (Δ = 6%). In multivariable CRMs, married status did not independently predict lower CSM (hazard ratio [HR]: 0.74, p = 0.06). In males, 5-year CSM-FS rates were 89% for married versus 86% for unmarried patients (Δ = 3%). In multivariable CRMs, married status did not independently predict lower CSM (HR: 0.85, p = 0.4). In females, 5-year CSM-FS rates were 88% for married versus 79% for unmarried patients (Δ = 9%). In multivariable CRMs, married status independently predicted lower CSM (HR: 0.58, p = 0.03). CONCLUSIONS In nonmetastatic pelvic liposarcoma patients, married status independently predicted lower CSM only in female patients. In consequence, unmarried female patients should ideally require more assistance and more frequent follow-up than their married counterparts.
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Affiliation(s)
- Andrea Baudo
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada
- Department of Urology, IRCCS Policlinico San Donato, Milan, Italy
| | - Simone Morra
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Lukas Scheipner
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Letizia Maria Ippolita Jannello
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada
- Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Mario de Angelis
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada
- Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carolin Siech
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada
- Department of Urology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany
| | - Nawar Touma
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada
| | - Jordan A Goyal
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada
| | - Zhe Tian
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada
| | - Pietro Acquati
- Department of Urology, IRCCS Policlinico San Donato, Milan, Italy
| | - Nicola Longo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Sascha Ahyai
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Ottavio de Cobelli
- Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Alberto Briganti
- Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Felix K H Chun
- Department of Urology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany
| | - Fred Saad
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Department of Urology, Weill Cornell Medical College, New York, New York, USA
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Hourani Center of Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
| | - Luca Carmignani
- Department of Urology, IRCCS Policlinico San Donato, Milan, Italy
- Department of Urology, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy
| | - Pierre I Karakiewicz
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada
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Avila J, DuMontier C, Cernik C, Uno H, Hshieh T, Ho K, Mozessohn L, Driver JA, Abel GA. Marital status, frailty, and survival in older adults with blood cancer. J Geriatr Oncol 2023; 14:101589. [PMID: 37453810 DOI: 10.1016/j.jgo.2023.101589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/12/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Jorge Avila
- Department of Medicine, St Elizabeth's Medical Center, Boston, MA, USA; Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Clark DuMontier
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA; New England Geriatrics Research, Education and Clinical Center, VA Boston Healthcare System, Boston, MA, USA; Division of Aging, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Colin Cernik
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Hajime Uno
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Tammy Hshieh
- Division of Aging, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Kristi Ho
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Lee Mozessohn
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, USA
| | - Jane A Driver
- New England Geriatrics Research, Education and Clinical Center, VA Boston Healthcare System, Boston, MA, USA; Division of Aging, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Gregory A Abel
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA; Division of Hematologic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
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Krajc K, Miroševič Š, Sajovic J, Klemenc Ketiš Z, Spiegel D, Drevenšek G, Drevenšek M. Marital status and survival in cancer patients: A systematic review and meta-analysis. Cancer Med 2023; 12:1685-1708. [PMID: 35789072 PMCID: PMC9883406 DOI: 10.1002/cam4.5003] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 06/13/2022] [Accepted: 06/13/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND In recent years, authors have repeatedly reported on the significance of social support in cancer survival. Although overall the studies appear to be convincing, little is known about which types of social support promote better survival rates, and which subgroups of cancer patients are more susceptible to the benefits of it. The aim of this study was to identify, organize, and examine studies reporting on the significance of social support in cancer survival. METHODS The PubMed, CINAHL and EBSCO databases were searched using the keywords social support/marital status, cancer, and survival/mortality. Where possible we used a meta-analytical approach, specifically a random effect model, in order to combine the results of the hazard ratios in studies from which this information could be obtained. When interpreting clinical relevance, we used the number needed to treat (NNT). RESULTS Better survival was observed in married patients when compared to unmarried (single, never-married, divorced/separated, and widowed) in overall and cancer-specific survival. Gender group differences showed that the association was statistically significant only in cancer-specific survival when comparing divorced/separated male and female cancer patients (p < 0.001), thus confirming results from the previous meta-analysis. CONCLUSIONS Being unmarried is associated with significantly worse overall and cancer-specific survival. The most vulnerable group found in our study were divorced/separated men. The results of this review can motivate physicians, oncologists, and other healthcare professionals to be aware of the importance of patients' social support, especially in the identified sub-group.
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Affiliation(s)
- Kaja Krajc
- Faculty of Mathematics, Natural Sciences and Information TechnologiesUniversity of PrimorskaKoperSlovenia
| | - Špela Miroševič
- Department of Family Medicine, Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
| | - Jakob Sajovic
- Department of StomatologyUniversity Medical Centre LjubljanaLjubljanaSlovenia
| | - Zalika Klemenc Ketiš
- Department of Family Medicine, Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
- Department of Family Medicine, Faculty of MedicineUniversity of MariborMariborSlovenia
- Community Health Centre LjubljanaLjubljanaSlovenia
| | - David Spiegel
- Department of Psychiatry and Behavioural SciencesStanford University School of MedicineStanfordCaliforniaUSA
| | - Gorazd Drevenšek
- Institute of Pharmacology and Experimental Toxicology, Faculty of Medicine LjubljanaUniversity of LjubljanaLjubljanaSlovenia
| | - Martina Drevenšek
- Department of StomatologyUniversity Medical Centre LjubljanaLjubljanaSlovenia
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Wen Y, Zhang H, Zhi K, Li M. Influence of marital status on the treatment and survival of middle-aged and elderly patients with primary bone cancer. Front Med (Lausanne) 2022; 9:1001522. [DOI: 10.3389/fmed.2022.1001522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThe role of spousal support has been recognized to benefit patients with many chronic diseases and cancers. However, the impact of marital status on the survival of middle-aged and elderly patients with primary bone tumors remains elusive.Materials and methodsThe data of patients aged ≥ 45 years with primary bone tumors diagnosed between 2000 and 2018 were extracted from the Surveillance, Epidemiology, and End Results Database. Kaplan–Meier analysis was used to assess the overall survival and tumor-specific survival of patients. The Cox proportional hazards and Fine-and-Gray models were used to calculate the hazard ratios (HRs) and sub-distribution HRs (sHR) and the corresponding 95% confidence interval (CI) of all-cause mortality and tumor-specific mortality, respectively.ResultsA total of 5,640 primary bone tumors were included in the study. In 45–59 years cohort, married, unmarried, divorced and widowed accounted for 66.0, 21.0, 11.2, and 1.8%, respectively; while 64.3, 10.1, 8.8, and 16.8% in 60+ years cohort, respectively. The widowed patients had a lower proportion of early-stage tumors at diagnosis than that married, unmarried, and divorced patients (31.0% vs. 36% vs. 37.1% vs. 39.4%; P = 0.008), and had a higher proportion of patients who did not undergo surgery than that of married, unmarried, and divorced patients (38.6% vs. 21.3% vs. 24.6% vs. 24.4%; P < 0.001). The widowed population had an increased risk of all-cause mortality (HR, 1.68; 95% CI, 1.50–1.88; P < 0.001) and disease-related mortality (HR, 1.33; 95% CI, 1.09–1.61; P = 0.005) compared with the married population.ConclusionThe marital status of middle-aged and elderly people can affect the tumor stage at diagnosis, treatment, and survival prognosis of patients with primary bone cancer. Widowed patients are more inclined to choose non-surgical treatment and have the worst prognosis.
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Pan D, Wang M, Liu W, Li Y, Sang L, Chang B. Clinical-pathological characteristics and prognostic factors for malignant peritoneal mesothelioma in the elderly. BMC Gastroenterol 2022; 22:292. [PMID: 35681152 PMCID: PMC9185976 DOI: 10.1186/s12876-022-02361-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 05/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malignant peritoneal mesothelioma (MPM) is a rare disease characterized by atypical symptoms, difficult diagnosis, variable course and poor prognosis, and it develops mainly in elderly individuals. The authors aimed to identify the clinical-pathological characteristics, prognosis, and prognostic factors in elderly MPM patients. METHODS From the National Cancer Institute Surveillance Epidemiology End Results (SEER) database, 1492 patients with MPM from 1975 to 2016 were selected and divided into the elderly group (≥ 65) and the adult group (< 65). We compared the clinical-pathological characteristics and treatment methods of the elderly group (N = 665) and the adult group (N = 827). At the same time, we analysed specific selected clinicopathological parameters and prognostic factors for elderly MPM patients. RESULTS Compared with the adult group, the elderly group had higher percentages of male patients (P = 0.017) and white patients (P = 0.043) and lower proportions of insured patients (P < 0.001) married patients (P < 0.001), patients with peritoneal tumours (P = 0.006) and patients who underwent surgery (P < 0.001) and chemotherapy (P < 0.001). There was a significant difference in the differentiation grade between the two groups (P = 0.003). Elderly patients had a shorter median survival time than adult patients (6 months vs. 19 months). Uninsured (hazard ratio (HR): 5.187, P = 0.005), sarcomatoid type (HR 3.913, P < 0.001), poorly differentiated (HR 3.900, P < 0.001), distant metastasis (HR 1.735, P = 0.001), no cancer-directed surgery (HR 1.733, P < 0.001), and no chemotherapy (HR 1.532, P < 0.001) were independently associated with poorer prognosis in elderly MPM patients. CONCLUSION Compared with adult patients, elderly MPM patients had a higher male ratio, poor differentiation and relatively conservative treatment. The cancer-specific survival (CSS) rate of elderly MPM patients was significantly lower than that of adult patients. Insurance status, histology type, differentiation grade, stage, surgery status, and chemotherapy status were all independent prognostic factors for elderly MPM patients.
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Affiliation(s)
- Dan Pan
- Department of Geriatrics, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Mengyao Wang
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Wencheng Liu
- Department of Gastroenterology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yan Li
- Department of Gastroenterology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Lixuan Sang
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Bing Chang
- Department of Gastroenterology, The First Affiliated Hospital of China Medical University, Shenyang, China.
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Demirtaş T, Temircan Z. Examining the Relationship between Depression, Anxiety and Stress in Kidney Cancer Patients. J Kidney Cancer VHL 2021; 9:19-26. [PMID: 35083112 PMCID: PMC8720243 DOI: 10.15586/jkcvhl.v9i5.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/17/2021] [Indexed: 06/14/2023] Open
Abstract
Cancer of the kidney is one of the 10 most common cancers found globally. Overall, it is the fourth most common cancer in men and the eighth most common cancer in women. Many kidney cancer patients experience psychologic problems and reactions. The present study examined relationship between anxiety, depression, and perceived stress symptoms in kidney cancer patients. Cross-sectional data were obtained from the patients diagnosed with kidney cancer. All participants completed sociodemographic form, Hospital Anxiety and Depression form, and Perceived Stress Scale. Statistical analysis was exercised using the Student's t-test, Chi-squared test (χ2), Fischer's exact test, ANOVA, Mann-Whitney U test, and Kruskal-Wallis one-way variance analysis. A total of 250 patients participated in the study. The mean age was 57.4 years (SD 6.4, range = 25-76 years). The majority of patients were males (73%) and married (218). Anxiety symptoms were determined in 91.2% patients, depression symptoms in 87.2% patients, and perceived stress symptoms in 93.6% patients. The mean scores of Hospital Depression and Anxiety Scale (HADS)-Anxiety, HADS-Depression, and HADS-Perceived Stress were significantly different between age (P < 0.05), gender (P < 0.05), and income groups (P < 0.001). Kidney cancer patients showed poorer psychologic health. The overall levels of anxiety, depression, and perceived stress symptoms were higher among the studied kidney cancer patients. Findings of the current study could improve both psychologic well-being of patients and health-related quality of life.
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Affiliation(s)
- Türev Demirtaş
- Department of Medical Ethics and History, Erciyes University School of Medicine, Merkez Kampüs Talas Yolu Melikgazi, Kayseri, Turkey
| | - Zekeriya Temircan
- Department of Psychology, Kapadokya University, Yeni, Ürgüp, Nevs ¸ehir, Turkey
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10
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Wilson LE, Spees L, Pritchard J, Greiner MA, Scales CD, Baggett CD, Kaye D, George DJ, Zhang T, Wheeler SB, Dinan MA. Real-World Utilization of Oral Anticancer Agents and Related Costs in Older Adults with Metastatic Renal Cell Carcinoma in the United States. KIDNEY CANCER 2021; 5:115-127. [PMID: 34632169 PMCID: PMC8474520 DOI: 10.3233/kca-210119] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 05/21/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Substantial racial and socioeconomic disparities in metastatic RCC (mRCC) have persisted following the introduction of targeted oral anticancer agents (OAAs). The relationship between patient characteristics and OAA access and costs that may underlie persistent disparities in mRCC outcomes have not been examined in a nationally representative patient population. METHODS Retrospective SEER-Medicare analysis of patients diagnosed with mRCC between 2007-2015 over age 65 with Medicare part D prescription drug coverage. Associations between patient characteristics, OAA receipt, and associated costs were analyzed in the 12 months following mRCC diagnosis and adjusted to 2015 dollars. RESULTS 2,792 patients met inclusion criteria, of which 32.4%received an OAA. Most patients received sunitinib (57%) or pazopanib (28%) as their first oral therapy. Receipt of OAA did not differ by race/ethnicity or socioeconomic indicators. Patients of advanced age (> 80 years), unmarried patients, and patients residing in the Southern US were less likely to receive OAAs. The mean inflation-adjusted 30-day cost to Medicare of a patient's first OAA prescription nearly doubled from $3864 in 2007 to $7482 in 2015, while patient out-of-pocket cost decreased from $2409 to $1477. CONCLUSION Race, ethnicity, and socioeconomic status were not associated with decreased OAA receipt in patients with mRCC; however, residing in the Southern United States was, as was marital status. Surprisingly, the cost to Medicare of an initial OAA prescription nearly doubled from 2007 to 2015, while patient out-of-pocket costs decreased substantially. Shifts in OAA costs may have significant economic implications in the era of personalized medicine.
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Affiliation(s)
- Lauren E Wilson
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Lisa Spees
- Department of Health Policy and Management, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Jessica Pritchard
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Melissa A Greiner
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Charles D Scales
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.,Department of Surgery (Urology), Duke University School of Medicine, Durham, NC, USA.,Duke Clinical Research Institute, Durham, NC, USA
| | - Christopher D Baggett
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA.,Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Deborah Kaye
- Department of Surgery (Urology), Duke University School of Medicine, Durham, NC, USA.,Duke Cancer Institute Center for Prostate and Urologic Cancers, Durham, NC, USA.,Duke-Margolis Center for Health Policy, Durham, NC, USA
| | - Daniel J George
- Duke Cancer Institute Center for Prostate and Urologic Cancers, Durham, NC, USA.,Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Tian Zhang
- Duke Cancer Institute Center for Prostate and Urologic Cancers, Durham, NC, USA.,Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Stephanie B Wheeler
- Department of Health Policy and Management, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Michaela A Dinan
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.,Department of Epidemiology, Yale University, New Haven, CT, USA
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Liu Q, Zhang R, Li Q, Li X. Clinical Implications of Nonbiological Factors With Colorectal Cancer Patients Younger Than 45 Years. Front Oncol 2021; 11:677198. [PMID: 34307145 PMCID: PMC8293297 DOI: 10.3389/fonc.2021.677198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 06/23/2021] [Indexed: 11/13/2022] Open
Abstract
Background To evaluate the clinical implications of non-biological factors (NBFs) with colorectal cancer (CRC) patients younger than 45 years. Methods In the present study, we have conducted Cox proportional hazard regression analyses to evaluate the prognosis of different prognostic factors, the hazard ratios (HRs) were shown with 95% confidence intervals (CIs). Kaplan-Meier method was utilized to compare the prognostic value of different factors with the log-rank test. NBF score was established according to the result of multivariate Cox analyses. Results In total, 15129 patients before 45 years with known NBFs were identified from the SEER database. Only county-level median household income, marital status and insurance status were NBFs that significantly corelated with the cause specifical survival in CRC patients aged less than 45 years old (P < 0.05). Stage NBF 1 showed 50.5% increased risk of CRC-specific mortality (HR = 1.505, 95% CI = 1.411-1.606, P < 0.001). Stage NBF 0 patients were associated with significantly increased CRC-specific survival (CCSS) when compared with the stage NBF 1 patients in different AJCC TNM stages. Conclusions NBF stage (defined by county-level median household income, marital status and insurance status) was strongly related to the prognosis of CRC patients. NBFs should arouse enough attention of us in clinical practice of patients younger than 45 years.
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Affiliation(s)
- Qi Liu
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ruoxin Zhang
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Qingguo Li
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xinxiang Li
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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12
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Liu K, Lin C, Zhang L. Novel Prediction Models for Patients With Oral Squamous Cell Carcinoma at Different Anatomical Sites. J Oral Maxillofac Surg 2021; 79:2358-2369. [PMID: 34331871 DOI: 10.1016/j.joms.2021.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/07/2021] [Accepted: 06/14/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The individualized prediction of oral cavity squamous cell carcinoma (OC-SCC) is essential and should be as comprehensive as possible. The aim of this study was to identify new risk factors and develop nomograms comparing all anatomic sites of the oral cavity. MATERIALS AND METHODS We performed a retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) database. All patients with OC-SCC diagnosed from 2004 to 2015 were selected and divided into the training cohort and the validation cohort. Age, gender, race, marital status, primary site, tumor grade, American Joint Committee on Cancer (AJCC) stage, TNM stage, surgical treatment, radiotherapy and chemotherapy were identified as predictor variables. The overall survival (OS) and disease specific survival (DSS) were identified as outcome variables. Kaplan-Meier method with log-rank test, univariate and multivariate cox regression analysis were performed. Independent prognostic factors were used to develop 3- and 5-year nomograms. Hazard ratio (HR) and corresponding 95% confidence interval (CI) showed the influence of each factor on OS or DSS. Concordance indexes (C-indexes) and calibration curves verified the nomograms internally and externally. RESULTS A total of 12,346 patients were included. Marital status and chemotherapy were independent prognostic factors (P < .05). Tumors occurring on the cheek mucosa had the highest risk in OS (HR, 2.0, 95% CI, 1.7-2.3) and DSS (HR, 4.7, 95% CI, 3.6-6.0), while tumors occurring on the lip had the lowest risk in OS (HR, 1.0) and DSS (HR,1.0). The C-indexes for OS in the training and validation sets were 0.767 and 0.770, respectively, and for DSS were 0.800 and 0.799, respectively. CONCLUSION Marital status and chemotherapy independently affect OC-SCC patients' survival. The prognosis is least favorable for tumors occurring on the cheek mucosa and most favorable for tumors occurring on the lip.
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Affiliation(s)
- Keyuan Liu
- Resident, School of Clinical Stomatology, Tianjin Medical University, Tianjin, China
| | - Chen Lin
- Resident, School of Clinical Stomatology, Tianjin Medical University, Tianjin, China
| | - Linkun Zhang
- Professor, Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China; Professor, Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, China.
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13
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Gao TM, Bai DS, Qian JJ, Zhang C, Jin SJ, Jiang GQ. Real-world clinical significance of nonbiological factors with staging, prognosis and clinical management in rectal cancer. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2020; 47:990-998. [PMID: 33046280 DOI: 10.1016/j.ejso.2020.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/03/2020] [Accepted: 10/05/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND The clinical guidance of the American Joint Committee on Cancer (AJCC) tumor, node, metastasis (TNM) staging system is established only in biological factors and does not include nonbiological factors (NBFs). We assessed the clinical value of incorporating NBFs into the TNM staging system in point of the clinical management and prognostic prediction accuracy of rectal cancer. METHODS We used the Surveillance, Epidemiology and End Results (SEER) database and identified 12,515 patients with rectal cancer who were diagnosed between 1 January 2011 and 31 December 2015. Multivariate Cox proportional hazards regression analysis and Kaplan-Meier curves were used to determine the probabilities of cancer-specific survival (CSS) according to different TNM-NBF stages. RESULTS Multivariate Cox regression analysis showed that county percentage with a bachelor's degree, insurance status, unemployment status, and marital status were all significant prognostic NBFs (p < 0.05). The concordance index of TNM-NBF stages was 0.815 (95% confidence interval (CI) 0.8072-0.8228). Multivariate Cox analyses showed that, compared with NBF0-stage, NBF1-stage was contacted with a 54.5% increased risk of cancer-specific mortality in rectal cancer, which increased to 68.3% in non-metastatic rectal cancer (all p < 0.001). NBF0-stage showed a CSS benefit as compared with NBF1-stage (p < 0.001). CONCLUSIONS We found that NBF-stage was an independent prognostic factor for survival in rectal cancer. The influence of NBFs on survival in rectal cancer warrants greater clinical attention. Furthermore, the consolidation of NBF-stage into the TNM staging system is crucial to better prognostic prediction accuracy and individualized risk-adaptive therapies.
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Affiliation(s)
- Tian-Ming Gao
- Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, China; Department of Hepatobiliary Surgery, The Second Clinical College, Dalian Medical University, Dalian, 116044, China
| | - Dou-Sheng Bai
- Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, China
| | - Jian-Jun Qian
- Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, China
| | - Chi Zhang
- Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, China
| | - Sheng-Jie Jin
- Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, China
| | - Guo-Qing Jiang
- Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, China.
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Unmarried men have worse oncologic outcomes after radical cystectomy for nonmetastatic urothelial bladder cancer. Urol Oncol 2020; 38:76.e1-76.e9. [DOI: 10.1016/j.urolonc.2019.10.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/22/2019] [Accepted: 10/29/2019] [Indexed: 02/08/2023]
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15
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Mytsyk Y, Pasichnyk S, Dutka I, Dats I, Vorobets D, Skrzypczyk M, Uteuliyev Y, Botikova A, Gazdikova K, Kubatka P, Urdzik P, Kruzliak P. Systemic treatment of the metastatic renal cell carcinoma: usefulness of the apparent diffusion coefficient of diffusion-weighted MRI in prediction of early therapeutic response. Clin Exp Med 2020; 20:277-287. [PMID: 32026157 DOI: 10.1007/s10238-020-00612-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 01/27/2020] [Indexed: 12/21/2022]
Abstract
Accurate prediction of early treatment response to systemic therapy (ST) with tyrosine kinase inhibitors (TKI) in patients with metastatic renal cell carcinoma (mRCC) could help avoid ineffective and expensive treatment with serious side effects. Neither RECIST v.1.1 nor Choi criteria successfully discriminate between patients with mRCC who received ST having a short or long time to progression (TTP). There is no biomarker, which is able to predict early therapeutic response to TKIs application in patients with mRCC. The goal of our study was to investigate the potential of apparent diffusion coefficient (ADC) of diffusion-weighted imaging (DWI) of MRI in prediction of early therapeutic response to ST with pazopanib in patients with mRCC. The retrospective study enrolled 32 adult patients with conventional mRCC who received pazopanib (mean duration-7.5 ± 3.45). The mean duration of follow-up was 11.85 ± 4.34 months. In all patients as baseline examination and 1 month after treatment, 1.5T MRI including DWI sequence was performed followed by ADC measurement of the main renal lesion. For assessment of the therapeutic response, RECIST 1.1 is used. Partial response (PR), stable disease (SD) and progressive disease (PD) were observed in 12 (37.50%), 10 (31.25%) and 10 (31.25%) cases with mean TTP of 10.33 ± 2.06 months (95% confidence interval, CI = 9.05-11.61), 7.40 ± 2.50 months (95% CI = 5.61-9.19) and 4.20 ± 1.99 months (95% CI = 2.78-5.62) accordingly (p < 0.05). There was no difference in change of main lesions' longest size 1 month after ST in patients with PR, SD and PD. Comparison of mean ADC values before and 1 month after systemic treatment showed significant decrease by 19.11 ± 10.64% (95% CI = 12.35-25.87) and by 7.66 ± 6.72% (95% CI = 2.86-12.47) in subgroups with PR and SD, respectively (p < 0.05). There was shorter TTP in patients with mRCC if ADC of the main renal lesion 1 month after the ST increased from the baseline less than 1.73% compared to patients with ADC levels above this threshold: 5.29 ± 3.45 versus 9.50 ± 2.04 months accordingly (p < 0.001). Overall, our findings highlighted the use of ADC as a predictive biomarker for early therapeutic response assessment. Use of ADC will be effective and useful for reliable prediction of responders and non-responders to systemic treatment with pazopanib.
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Affiliation(s)
- Yulian Mytsyk
- Department of Urology, Lviv National Medical University n.a. Danylo Halytsky, Pekarska Str. 69, Lviv, Ukraine
| | - Serhiy Pasichnyk
- Department of Urology, Lviv National Medical University n.a. Danylo Halytsky, Pekarska Str. 69, Lviv, Ukraine
| | - Ihor Dutka
- Medical center "Euroclinic", Lviv, Ukraine
| | - Ihor Dats
- Department of Radiology, Lviv National Medical University n.a. Danylo Halytsky, Lviv, Ukraine
| | - Dmytro Vorobets
- Department of Urology, Lviv National Medical University n.a. Danylo Halytsky, Pekarska Str. 69, Lviv, Ukraine
| | - Michał Skrzypczyk
- Department of Urology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Yerzhan Uteuliyev
- Department of Postgraduate Education and Research, Kazakhstan Medical University, Almaty, Kazakhstan
| | - Andrea Botikova
- Faculty of Health and Social Work, Trnava University, Trnava, Slovakia
| | - Katarina Gazdikova
- Department of General Medicine, Faculty of Medicine, Slovak Medical University, Limbova 12, 8303, Bratislava, Slovakia
| | - Peter Kubatka
- Department of Medical Biology, Jessenius Faculty of Medicine in Martin, Comenius University, Martin, Slovakia
| | - Peter Urdzik
- Department of Gynaecology and Obstetrics, Faculty of Medicine, Pavol Jozef Safarik University and Louis Pasteur University Hospital, Tr. SNP 1, 04001, Kosice, Slovakia
| | - Peter Kruzliak
- Department of Internal Medicine, Brothers of Mercy Hospital, Polni 553/3, 63900, Brno, Czech Republic.
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Qiu S, Tao L, Zhu Y. Marital Status and Survival in Osteosarcoma Patients: An Analysis of the Surveillance, Epidemiology, and End Results (SEER) Database. Med Sci Monit 2019; 25:8190-8203. [PMID: 31672959 PMCID: PMC6849371 DOI: 10.12659/msm.918048] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background As the most malignant bone tumor globally, osteosarcoma has drawn increased attention. However, no studies have focused on the association between marital status and survival rate. The objectives of this study were to determine the association between marital and survival rate of osteosarcoma patients based on the SEER database. Material/Methods We enrolled a total of 2725 osteosarcoma patients between 1973 and 2015, including 1184 married, 154 divorced/separated, 136 widowed, and 1251 never-married patients. Survival rate was determined based on the Kaplan-Meier method in different marital subgroups. Multivariate Cox regression analysis was performed to explore independent prognostic factors. Results The 5-year overall survival (OS) and cancer-specific survival (CSS) rates of the married, separated/divorced, widowed, and never-married subjects were 45.93%, 41.39%, 19.08%, and 57.21% (OS), and 49.97%, 45.85%, 22.14%, and 60.69% (CSS), respectively. The survival outcome among subgroups exhibited a clear difference, with a log-rank test p-value <0.0001. Multivariate Cox regression showed that widowhood served as the independent prognostic factor for decreased OS rather than marriage (HR, 1.246; 95% CI, 1.011–1.536; p-value=0.039) and CSS (HR, 1.34; 95% CI, 1.07–1.68; p-value=0.01). Moreover, the OS and CSS in widowed patients were lower. Additionally, based on the propensity score matching (PSM) method, the prognosis of married patients was better than that of unmarried subjects. Conclusions Marital status was correlated with the survival rate, meaning that married patients had higher survival than widowed subjects, who had worse prognoses of osteosarcoma.
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Affiliation(s)
- Shui Qiu
- Department of Orthopaedics, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Lin Tao
- Department of Orthopedics, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Yue Zhu
- Department of Orthopedics, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
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Rosiello G, Knipper S, Palumbo C, Dzyuba-Negrean C, Pecoraro A, Mazzone E, Mistretta FA, Tian Z, Capitanio U, Montorsi F, Shariat SF, Saad F, Briganti A, Karakiewicz PI. Unmarried status is a barrier for access to treatment in patients with metastatic renal cell carcinoma. Int Urol Nephrol 2019; 51:2181-2188. [PMID: 31468289 DOI: 10.1007/s11255-019-02266-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 08/22/2019] [Indexed: 01/12/2023]
Abstract
PURPOSE We tested the effect of marital status on cytoreductive nephrectomy, metastasectomy, and systemic therapy rates, as well as on cancer-specific mortality (CSM) in patients with metastatic clear cell renal carcinoma (mccRCC). METHODS Within the Surveillance, Epidemiology and End Results database (2004-2015), we identified 6975 patients (4806 men and 2169 women) with metastatic clear cell renal carcinoma. Temporal trend analyses, logistic regression models, cumulative incidence plots, and competing-risk regression models were used. RESULTS Overall, 1450 men and 1018 women were unmarried (30.2% and 47.0%, respectively). In men, unmarried status was an independent predictor of lower cytoreductive nephrectomy rate (OR: 0.54), lower metastasectomy rate (OR: 0.70), and lower systemic therapy rate (OR: 0.70). Conversely, in women, unmarried status was an independent predictor of lower cytoreductive nephrectomy rate (OR: 0.63) and of lower systemic therapy rate (OR: 0.80), but not of lower metastasectomy rate (OR: 0.83; p = 0.12). In multivariable competing-risk regression analyses, unmarried status was an independent predictor of higher CSM in men (HR: 1.15), but not in women (HR 0.97, p = 0.6). CONCLUSIONS Unmarried men are at higher risk of not benefiting of cytoreductive nephrectomy, metastasectomy, or systemic therapy than their married counterparts. Unmarried women are at higher risk of not benefiting of cytoreductive nephrectomy or systemic therapy. These gender-related differences cumulate in higher CSM in unmarried men, but not in unmarried women.
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Affiliation(s)
- Giuseppe Rosiello
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada. .,Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Via Olgettina, 52, 20132, Milan, Italy.
| | - Sophie Knipper
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada.,Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Carlotta Palumbo
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada.,Urology Unit, ASST Spedali Civili of Brescia, Department of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - Cristina Dzyuba-Negrean
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada
| | - Angela Pecoraro
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada.,Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
| | - Elio Mazzone
- Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Via Olgettina, 52, 20132, Milan, Italy
| | - Francesco A Mistretta
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada.,Department of Urology, European Institute of Oncology, Milan, Italy
| | - Zhe Tian
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada
| | - Umberto Capitanio
- Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Via Olgettina, 52, 20132, Milan, Italy
| | - Francesco Montorsi
- Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Via Olgettina, 52, 20132, Milan, Italy
| | | | - Fred Saad
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada
| | - Alberto Briganti
- Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Via Olgettina, 52, 20132, Milan, Italy
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada
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Tao L, Yu H, Dong Y, Tian G, Ren Z, Li D. Metastases with definitive pathological diagnosis but no detectable primary tumor: A surveillance epidemiology and end results-based study. Cancer Med 2019; 8:5872-5880. [PMID: 31407505 PMCID: PMC6792521 DOI: 10.1002/cam4.2496] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 07/31/2019] [Accepted: 07/31/2019] [Indexed: 12/24/2022] Open
Abstract
Background This study investigates the characteristics of a special type of cancer of unknown primary site (CUP, type 2), which is a metastasis of a definite pathological diagnosis without a detectable primary site. Patients and methods Patients diagnosed between 2004 and 2014 were identified from the Surveillance Epidemiology and End Results (SEER) database. The characteristics of type 2 CUP from different sources were analyzed. For each source of type 2 CUP, tumors of the corresponding TnN0‐XM1 stage were used as controls. Results A total of 8505 patients with type 2 CUP were included in this analysis. Type 2 CUP shows an increasing trend, while type 1 shows the opposite. Type 2 CUPs have significant differences with stage IV of the same pathological primary lesion. Many characteristics influenced the prognosis of type 2 CUP patients, including marital status, age, race, sex, registration time, lymph node metastasis, surgery, chemotherapy, and radiation. Conclusion Our study suggests that identifying the source of metastasis is the key to the selection of treatment and the determination of the prognosis for CUP.
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Affiliation(s)
- Lianyuan Tao
- Department of Hepatobiliary Surgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, China
| | - Haibo Yu
- Department of Hepatobiliary Surgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, China
| | - Yadong Dong
- Department of Hepatobiliary Surgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, China
| | - Guanjing Tian
- Department of Hepatobiliary Surgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, China
| | - Zhiyuan Ren
- Department of Hepatobiliary Surgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, China
| | - Deyu Li
- Department of Hepatobiliary Surgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, China
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Zhang SL, Zhang ZY, Liu ZJ, Wang WR, Li ZM, Han B, Wang X, Wang LS. A real-world study of socioeconomic factors with survival in adults aged 18-64 years with renal cell carcinoma. Future Oncol 2019; 15:2503-2515. [PMID: 31240959 DOI: 10.2217/fon-2018-0827] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Aim: To evaluate the impact of socioeconomic factors (SEFs) on survival of renal cell carcinoma (RCC) patients. Materials & methods: RCC patients diagnosed between 2007 and 2015 were collected from the SEER database. The crude and multivariate Cox regression analysis was used to identify the independent prognostic factors and quantity the mortality risks for overall survival (OS). Results: Three SEFs including marital status, insurance status and median household income were identified as prognostic factors for OS. SEF-stage was built based on the three SEFs. Moreover, the SEF-stage 1 had superior OS than SEF-stage 2 within the respective American Joint Committee on Cancer stages. Conclusion: The SEF-stage was an independently prognostic factor for OS in RCC. Incorporation of SEF-stage into the American Joint Committee on Cancer staging system might be beneficial for better survival prediction and clinical management. However, further studies were needed to validate these findings in other populations.
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Affiliation(s)
- Shi-Long Zhang
- Institute of Fudan-Minhang Academic Health System, Minhang Branch, Zhongshan Hospital, Fudan University, Shanghai 201199, PR China
| | - Zheng-Yan Zhang
- Institute of Fudan-Minhang Academic Health System, Minhang Branch, Zhongshan Hospital, Fudan University, Shanghai 201199, PR China
| | - Ze-Juan Liu
- Department of Pharmacology, Capital Medical University, Beijing 100069, PR China
| | - Wen-Rong Wang
- College of Physical Education, Shandong Normal University, Jinan 250014, PR China
| | - Zhan-Ming Li
- Institute of Fudan-Minhang Academic Health System, Minhang Branch, Zhongshan Hospital, Fudan University, Shanghai 201199, PR China
| | - Bing Han
- Institute of Fudan-Minhang Academic Health System, Minhang Branch, Zhongshan Hospital, Fudan University, Shanghai 201199, PR China
| | - Xin Wang
- Department of Acupuncture & Moxibustion, Central Hospital of Shanghai Xuhui District, Shanghai 200031, PR China
| | - Li-Shun Wang
- Institute of Fudan-Minhang Academic Health System, Minhang Branch, Zhongshan Hospital, Fudan University, Shanghai 201199, PR China
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Zhang SL, Sun HT, Li ZM, Zhang ZY, Wang WR, Wang X, Wang ZM, Wang LS. A real-world 1:1 propensity-matched study revealed unmarried status was independently associated with worse survival for patients with renal clear cell carcinoma. J Cancer 2019; 10:3767-3777. [PMID: 31333794 PMCID: PMC6636301 DOI: 10.7150/jca.31744] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 05/07/2019] [Indexed: 01/18/2023] Open
Abstract
Background: Marital status has been reported as an independent prognostic factor for survival in various cancers, but it has been rarely studied in renal clear cell carcinoma (ccRCC). In this study, we aimed to assess the impact of marital status on the survival of ccRCC patients. Methods: We retrospectively investigated the Surveillance, Epidemiology, and End Results (SEER) database and identified 68599 of ccRCC patients between 1973 and 2015. These patients were divided into married, single, divorced and widowed groups. The survival differences among these groups were assessed by Kaplan-Meier method and log-rank test. Multivariate Cox regression analyses were performed to identify the overall survival (OS) and cancer-specific survival (CSS) independent factors. Furthermore, 1:1 propensity score matching (PSM) analysis was performed to minimize the potential confounding factors. Results: Of the 68599 ccRCC patients, 44553 (64.95%) patients were married, 7410 (10.80%) were divorced, 10663 (15.54%) were single, and 5973 (8.71%) were widowed. The 5-year OS was 79.0%, 73.8%, 77.3%, and 66.4 % in the married, divorced, single, and widowed groups, respectively (p = 0.001) and the corresponding 5-year CSS rates were 85.5%, 83.3%, 80.8%, 76.5%, respectively. Multivariate Cox regression analysis marital status was the independent prognostic factor for OS and CSS. Compared with the married patients, the divorced, single, and widowed patients faced increased higher mortality risks for OS and CSS. In stratified analyses by sex, surgery conditions and cancer stages, those unmarried patients still had worse prognosis. The results were further confirmed in the 1: 1 matched group. Conclusion: Unmarried ccRCC patients experienced worse survival than their married counterparts. Among the unmarried patients, the widowed suffered the highest mortality risks for OS and CSS.
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Affiliation(s)
- Shi-Long Zhang
- Institute of Fudan-Minhang Academic Health System, Minhang Branch, Zhongshan hospital, Fudan University, Shanghai 201199, P.R. China
| | - Hai-Tao Sun
- Shanghai Institute of Medical Imaging, Shanghai 200032, P.R. China.,Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Zhan-Ming Li
- Institute of Fudan-Minhang Academic Health System, Minhang Branch, Zhongshan hospital, Fudan University, Shanghai 201199, P.R. China
| | - Zheng-Yan Zhang
- Institute of Fudan-Minhang Academic Health System, Minhang Branch, Zhongshan hospital, Fudan University, Shanghai 201199, P.R. China
| | - Wen-Rong Wang
- Faculty of Physical Education, Shandong Normal University, Jinan 250014, P.R. China
| | - Xin Wang
- Department of acupuncture and moxibustion, Central Hospital of Shanghai Xuhui District, Shanghai 200031, P.R. China
| | - Zhi-Ming Wang
- Department of Medical oncology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, P.R. China.,Xiamen branch, Zhongshan Hospital, Fudan University, No. 668 Jinhu Road, Xiamen, 361000, P.R China
| | - Li-Shun Wang
- Institute of Fudan-Minhang Academic Health System, Minhang Branch, Zhongshan hospital, Fudan University, Shanghai 201199, P.R. China
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Marital status is associated with survival of patients with astrocytoma. J Clin Neurosci 2018; 56:79-87. [DOI: 10.1016/j.jocn.2018.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 06/10/2018] [Accepted: 07/08/2018] [Indexed: 12/23/2022]
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Xie JC, Yang S, Liu XY, Zhao YX. Effect of marital status on survival in glioblastoma multiforme by demographics, education, economic factors, and insurance status. Cancer Med 2018; 7:3722-3742. [PMID: 30009575 PMCID: PMC6089174 DOI: 10.1002/cam4.1688] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 05/20/2018] [Accepted: 06/18/2018] [Indexed: 12/17/2022] Open
Abstract
The relationship between marital status and glioblastoma multiforme (GBM) has not been addressed in depth. Here, we aimed to investigate the association between marital status and survival in GBM. We searched the Surveillance, Epidemiology, and End Results (SEER) database and extracted the data of eligible patients diagnosed with GBM after 2004. Marital status was classified as married, divorced/separated, widowed, and single. A Kaplan-Meier test was conducted to compare the survival curves of different groups. Multivariate Cox regression was performed to evaluate overall survival (OS) and cause-specific survival (CSS) in different groups. Subgroup analysis was applied according to demographics, typical education and income levels in the locale, and insurance status. A total of 30 767 eligible patients were included. The median OS values were 9, 7, 3, 9 months in married, divorced/separated, widowed, and single patients, respectively. After adjustment for other covariates, married patients had better OS and CSS than other patients had. In addition to marital status, demographic factors, disease progression factors, local educational level, and insurance status were also associated with survival in GBM. Furthermore, subgroup analyses revealed the protective effect of marriage in most of the comparisons. Notably, the protective effect of marriage becomes more and more apparent as time goes on. The advantageous effect of marriage on GBM survival is especially prominent in patients who are male, older than 60 years of age, White, or living in middle-income counties. In conclusion, marital status is an independent prognostic factor for GBM.
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Affiliation(s)
- Jun-Chao Xie
- Department of Neurology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Shuai Yang
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xue-Yuan Liu
- Department of Neurology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yan-Xin Zhao
- Department of Neurology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
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Abstract
Previous studies have shown that marital status is an independent prognostic factor for survival in several types of cancer. In this study, we investigated the effects of marital status on survival outcomes among renal cell carcinoma (RCC) patients.We identified patients diagnosed with RCC between 1973 and 2013 from the Surveillance, Epidemiology and End Results (SEER) database. Kaplan-Meier analysis and Cox regression were used to identify the effects of marital status on overall survival (OS) and cancer-specific survival (CSS).We enrolled 97,662 eligible RCC patients, including 64,884 married patients, and 32,778 unmarried (9831 divorced/separated, 9692 widowed, and 13,255 single) patients at diagnosis. The 5-year OS and CSS rates of the married, separated/divorced, widowed, and single patients were 73.7%, 69.5%, 58.3%, and 73.2% (OS), and 82.2%, 80.7%, 75.7%, and 83.3% (CSS), respectively. Multivariate Cox regression showed that, compared with married patients, widowed individuals showed poorer OS (hazard ratio, 1.419; 95% confidence interval, 1.370-1.469) and CSS (hazard ratio, 1.210; 95% confidence interval, 1.144-1.279). Stratified analyses and multivariate Cox regression showed that, in the insured and uninsured groups, married patients had better survival outcomes while widowed patients suffered worse OS outcomes; however, this trend was not significant for CSS.In RCC patients, married patients had better survival outcomes while widowed patients tended to suffer worse survival outcomes in terms of both OS and CSS.
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Affiliation(s)
- Yan Li
- Department of Anesthesia, The 4th Affiliated Hospital of Harbin Medical University
| | - Ming-xi Zhu
- Key Laboratory of Hepatosplenic Surgery, Ministry of Education, Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Si-hua Qi
- Department of Anesthesia, The 4th Affiliated Hospital of Harbin Medical University
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