Clinical Research Papers:
Impact of marital status during diagnosis on cancer-caused specific survival in acute myeloid leukemia patients: a case-control and population-based study
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Zhuojun Zheng1,2,3,4,*, Yuandong Zhu1, Xiaodong Li2,3,4,5,*, Wenwei Hu2,3,4,5 and Jingting Jiang2,3,4
1 Department of Hematology, The Third Affiliated Hospital of Soochow University, Changzhou, China
2 Department of Tumor Biological Treatment, The Third Affiliated Hospital of Soochow University, Changzhou, China
3 Cancer Immunotherapy Engineering Research Center of Jiangsu Province, Changzhou, China
4 Institute of Cell Therapy Soochow University, Changzhou, China
5 Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, China
* Co-first authors of this work
Jingting Jiang, email:
Wenwei Hu, email:
Keywords: acute myeloid leukemia, marital status, SEER, survival analysis, subgroup analysis
Received: November 24, 2016 Accepted: February 28, 2017 Published: April 09, 2017
Objective: This study investigated the impact of marital status on cancer-caused specific mortality among acute myeloid leukemia (AML) patients in the United States. Methods: We used the Surveillance, Epidemiology and End Results program to identify 50,825 patients who had their clinical and follow-up information available and were diagnosed for AML between the years 1988 and 2015. The univariate and multivariable Cox regression models were used to analyze the patient data, and to minimize the group differences due to covariates between groups, a 1:1 propensity score matching was used in subsequent subgroup analysis. Results: Our study demonstrated that married patients were less likely to die due to AML after adjusting for demographic and clinicopathological variables, than patients with variable unmarried status. Further analysis indicated that widowed, divorced and never married status correlated with poor cancer-cause specific survival than being married in almost all subgroups after being adjusted for the aforementioned variables (P<0.05). However, the difference between married and separated was not apparent. Moreover, similar survival analysis results were also observed in the 1:1 matched subgroups of marital status, but they displayed varied prognostic factors between them. The association of survival benefit with marriage in AML was consistent with the published survival benefit of conventional therapeutic approaches. Conclusion: Overall, our study concluded that unmarried AML patients were at greater risk of cancer-specific mortality than married, and thus indicated that physicians should focus on health care strategies that target social support, in order to reduce the cancer-specific mortality in unmarried patients.
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