Abstract
BackgroundTo investigate the impact of marital status on overall survival (OS) and create a prognostic nomogram predicting OS in distant-metastatic bladder cancer (DMBC) patients.MethodsThe Surveillance, Epidemiology, and End Results (SEER) database was explored to recruit DMBC patients from 2010 to 2015. Kaplan–Meier survival analysis was used to compare survival differences among different marital status. Univariate and multivariate analyses were used to screen for prognostic factors and then constructed the nomogram based on Cox proportional hazard regression models. Calibration plot diagrams and concordance index (C-index) were used to verify the prognostic nomogram.ResultsKaplan–Meier curves suggested the significant differences of OS among different marital status existed in total (P < 0.001), female (P = 0.011) and male (P = 0.001) DMBC patients, respectively. Multivariate analysis indicated marital status was an independent prognostic factor for OS of DMBC patients. Nomogram showed the contribution of marital status to predicting OS was small. Other independent prognostic factors included age, grade, histology type, surgery of primary site, chemotherapy, and metastasis pattern. By combining seven factors, we constructed a prognostic nomogram for DMBC patients. The C-index of this nomogram for OS prediction was 0.722 (95% CI 0.712–0.732). The calibration curves showed perfect consistency between observed and predictive survival.ConclusionsMarital status was an independent prognostic factor for OS of DMBC patients, but its contribution to predicting OS was small. The prognostic nomogram will provide an individualized evaluation of OS and guidance for suitable treatments in DMBC patients.
Highlights
Bladder cancer (BC) is the 10th most common cause of cancer and the 13th leading cause of cancer death in the world, with an estimated 549,000 new cases and 200,000 deaths in 2018 [1, 2]
The results indicated that age at diagnosis, marital status, grade, histology type, surgery of primary site, chemotherapy, and metastasis pattern were independent prognostic factors for overall survival (OS) (Table 3)
The C-index of this nomogram for OS prediction was 0.722, which was greater than 0.7, suggesting the suitability of our nomogram for distant-metastatic bladder cancer (DMBC) patients
Summary
Bladder cancer (BC) is the 10th most common cause of cancer and the 13th leading cause of cancer death in the world, with an estimated 549,000 new cases and 200,000 deaths in 2018 [1, 2]. BC is approximately four times more common in men than in women and is a disease of the elderly, with 80% of BC patients are over 65 years in the US [3]. Many studies have investigated the impact of marital status on survival of BC patients [4, 10,11,12,13]. As far as we know, there are few studies to explore the effect of marital status on survival and evaluate the magnitude of this effect in distant-metastatic bladder cancer (DMBC) patients. To investigate the impact of marital status on overall survival (OS) and create a prognostic nomogram predicting OS in distant-metastatic bladder cancer (DMBC) patients
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