Marital status and survival in patients with primary liver cancer
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Xing-Kang He1,2, Zheng-Hua Lin1,2, Yun Qian1,2, Daheng Xia3, Piaopiao Jin4 and Lei-Min Sun1,2
1Department of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University Medical School, Hangzhou, China
2Institute of Gastroenterology, Zhejiang University (IGZJU), Hangzhou, China
3Current address: Sir Run Run Shaw Hospital, Jianggan, China
4Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Lei-Min Sun, email: [email protected]
Keywords: primary liver cancer, marital status, surveillance, epidemiology and end results, survival analysis
Received: March 29, 2016 Accepted: July 19, 2016 Published: August 05, 2016
Background: Marital status is viewed as an independent prognostic factor for survival in various cancer types. However, its role in primary liver cancer has yet to be thoroughly explored.
Objective: To investigate the impact of marital status on survival outcomes among liver cancer patients.
Results: We finally identified 40,809 eligible liver cancer patients between 2004 and 2012, including 21,939 (53.8%) patients were married at diagnosis and 18,870 (46.2%) were unmarried (including 5,871 divorced/separated, 4,338 widowed and 8,660 single). Married patients enjoyed overall and cause-specific survival outcomes compared with patients who were divorced/separated, widowed, single, respectively. The survival benefit associated with marriage still persisted even after adjusted for known confounders. Widowed individuals were at greater risk of overall and cancer-specific mortality compared to other groups. Similar associations were observed in subgroup analyses according to SEER stage.
Materials and Methods: We used the Surveillance, Epidemiology and End Results (SEER) database to identify 40,809 patients diagnosed with primary liver cancer between 2004 and 2012. Kaplan-Meier analysis and Cox regression were performed to identify the influence of marital status on overall survival (OS) and liver cancer-specific survival (CSS).
Conclusions: In primary liver cancer patients, married patients enjoyed survival benefits while widowed persons suffered survival disadvantages in both overall survival and cancer-specific survival.
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