Abstract
Marital status has been demonstrated to be related to the survival of patients in various cancer types, but the relationship in the large population of non-small cell lung cancer (NSCLC) has rarely been studied. In this study, we retrospectively extracted 70006 eligible NSCLC patients from the Surveillance, Epidemiology, and End Results (SEER) database in the period from 2004 to 2012. Marital status was categorized as married, divorced/separated, widowed, and never married. Chi-square tests were used to investigate the association between marital status and other variables. The Kaplan-Meier test was adopted to compare survival curves of different groups. Multivariate Cox regression analyses were conducted to estimate the effect of marital status on overall survival (OS) and NSCLC cause-specific survival (CSS). We further performed subgroup analyses according to TNM stage and surgery condition. The results showed that marital status was an independent prognostic factor for OS and CSS of NSCLC patients. Subgroup analyses showed that the relationship between marital status and prognosis varies according to different conditions. Widowed patients with surgery were at greater risk of death across all stages and non-surgical unmarried patients at advanced stages suffered poorer prognosis than the married. To conclude, in the NSCLC patients, married patients had advantage over the unmarried in both OS and CSS.
Highlights
Lung cancer is the most common cancer among men worldwide in terms of incidence and mortality, and among women has the third highest incidence and is second after breast cancer in mortality [1]
A total of 70006 eligible non-small cell lung cancer (NSCLC) patients were identified during the study period in the SEER database, including 37074(52.96%) male and 32932(47.04%) female patients
We found that unmarried patients, including divorced/separated, widowed and never married, are at significantly greater risk of poorer prognosis
Summary
Lung cancer is the most common cancer among men worldwide in terms of incidence and mortality, and among women has the third highest incidence and is second after breast cancer in mortality [1]. American Cancer Society has estimated that there will be 222,500 new cases and 155,870 deaths caused by lung cancer in United States in 2017 [2]. The 5-year relative survival rate from 1995 to 2001 for lung cancer patients were only 15.7%, much lower than other cancers [3]. In recent years, many researches have demonstrated that marital status independently predicts the survival of a series of cancers including gastric cancer [8,9,10], colorectal cancer [11, 12], liver cancer [13], pancreatic cancer [14], and several other types of cancer [15,16,17,18], with larger population from the US Surveillance, Epidemiology and End Results (SEER) cancer database
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