Impact of marital status at diagnosis on the survival of patients with anal canal squamous cell carcinoma: a propensity score-matched analysis.

Abstract

Marital status has been shown to be an important psychosocial factor that plays an important role in the prognosis of various cancers. The effect of marital status on survival outcomes in anal canal squamous cell carcinoma has not been studied. The purpose of this study was to address this issue. According to the established screening criteria, we obtained 2429 patients with anal canal squamous cell carcinoma from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier analysis and multivariate Cox regression analysis were used to analyze the survival of anal canal squamous cell carcinoma patients with different marital status. 1:1 propensity score matching (PSM) was used to match 979 unmarried patients with 979 married patients to further demonstrate the effect of marital status on the survival of patients with anal canal squamous cell carcinoma. The 5-year overall survival (OS) rates of married, divorced/separated, single, and widowed patients with anal canal squamous cell carcinoma were 75.6%, 69.7%, 62.2%, and 51.3%, respectively and the corresponding 5-year cancer-specific survival (CSS) rates were 80.7%, 79.6%, 70.1%, and 68.9%, respectively. Multivariate Cox regression analysis showed that marital status, sex, race, SEER stage, tumor size, regional nodes positive, primary site surgery, chemotherapy, and radiotherapy were independent prognostic factors for OS and CSS, and also demonstrated that the widowed patients suffered the highest risk mortality. Furthermore, married patients were found to have better OS and CSS than unmarried patients both before and after propensity score matching. This study found that married patients with anal canal squamous cell carcinoma had better survival outcomes, while widowed patients had the worst OS and CSS.