Marital status is associated with superior survival in patients with esophageal cancer: a Surveillance, Epidemiology, and End Results study
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Lijun Du1, John J. Kim1,2, Binrui Chen1, Shuwen Zhu1 and Ning Dai1
1Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
2Division of Gastroenterology, Loma Linda University Medical Center, Loma Linda, CA, USA
Ning Dai, email: [email protected]
Keywords: marital status; esophageal cancer; survival; surveillance; epidemiology
Received: January 04, 2017 Accepted: August 23, 2017 Published: October 07, 2017
The impact of marital status on survival among patients with esophageal cancer has not been evaluated in the U.S. population in depth. The aim of the study was to investigate the impact of marital status on survival among patients diagnosed with esophageal cancer. The Surveillance, Epidemiology, and End Results (SEER) database was utilized to identify patients diagnosed with esophageal cancer between 1973 and 2013. Cox regression analysis was performed to evaluate for association between marital status on both cancer-specific and overall survival. Of the 69,139 patients with esophageal cancer, 35,863 (52%) had adenocarcinoma and 21,573 (31%) had distant SEER stage. At the time of diagnosis, 39,805 (57%) patients were married, 10,116 (15%) were single, 8,417 (12%) were divorced or separated, and 10,801 (16%) were widowed. Married patients had superior cancer-specific and overall survival compared to unmarried patients. Multivariate analysis demonstrated that single (adjusted hazard ratio (HR)=1.14, 95%CI 1.11-1.17; P<0.001), divorced or separated (HR=1.16, 95%CI 1.13-1.19; P<0.001), and widowed (HR=1.22, 95%CI 1.19-1.26; P<0.001) compared to married patients had higher risk of death from all causes. In conclusion, marital status was associated with superior survival among U.S. patients with esophageal cancer in a large population-based study.
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