Marital status is associated with survival of patients with astrocytoma

Abstract

The prognostic role of marital status in patients with astrocytoma has not been fully explored. In this study we investigated the association of marital status and survival of astrocytoma. We extracted the eligible patients with astrocytoma diagnosed after 2000 from the Surveillance, Epidemiology, and End Results (SEER) database. The marital status was classified into married, divorced/separated, widowed, and single. The differences in OS and CSS were compared using the Kaplan-Meier log-rank test, and multivariate Cox regression was applied to analyze the risk factors for OS and CSS. Subgroup analyses were conducted to explore the association of marital status with patients in different sex, age, race, histologic type based on 2016 WHO grade, year of diagnosis, median household income and surgery status. A total of 43, 324 eligible patients were included. The median overall survival is 17, 11, 9, 3 months in single, married, divorced/separated patients, and widowed patients, respectively. Although single patients seemed to have the longest overall survival, after adjusted for other co-variables, married patients had the best OS and CSS compared with others, while divorced/separated or widowed patients had the worst CSS in different subgroups. Furthermore, subgroup analyses revealed some interesting results such as the CSS showed no difference between single and married for women (P = 0.122). In conclusion, marital status was an independent prognostic factor for astrocytoma patients. The healthcare system should aware of that patients with an aborted marriage need more social and physiological support.