Advertisement

Marital status independently predicts non-small cell lung cancer survival: a propensity-adjusted SEER database analysis

  • Zongwei Chen
  • Kanhua Yin
  • Difan Zheng
  • Jie Gu
  • Jizhuang Luo
  • Shuai Wang
  • Haiquan ChenEmail author
Original Article – Cancer Research

Abstract

Purpose

Marital status has been demonstrated as an independent prognostic factor in many cancer types. The impact of marital status on non-small cell lung cancer (NSCLC) survival has not been assessed at the population level. Here, we used the surveillance, epidemiology and end results (SEER) database, a US national cancer registry, to address this issue.

Methods

All patients diagnosed with NSCLC from 2004 to 2009 were identified in the SEER database (version 8.3.2, updated at April 14, 2016). Those with incomplete clinicopathological information were excluded. The tumor, node, metastasis (TNM) staging was based on the criteria of the American Joint Committee on Cancer (AJCC) 6th edition. We used propensity-score matching analysis to balance baseline characteristics between the patients who were married and those who were not married. The impact of marital status on cancer-specific survival was analyzed with Cox proportional-hazards regression.

Result

A total of 72, 984 NSCLC patients (41, 095 married patients, 56.3%) were enrolled in this study. After propensity-score matching, 25, 617 patients in the married group were 1:1 matched with patients in the unmarried group. Being unmarried was found to be associated with significantly decreased cancer-specific survival (hazard ratio (HR): 1.142, 95% CI: 1.119–1.166, p < 0.001). Among the unmarried group, patients who were single had worse cancer-specific survival (median survival 12 months, 95% CI: 11.37–12.63 months) than those who were divorced (median survival 15 months, 95% CI: 14.24–15.76 months, p < 0.001) or widowed (median survival 15 months, 95% CI: 14.25–15.76 months, p < 0.001).

Conclusion

This study shows that marital status is an independent prognostic factor for cancer-specific survival in NSCLC patients. Patients who were married had better cancer-specific survival compared to the unmarried ones.

Keywords

Non-small cell lung cancer Marital status Prognosis 

Notes

Author contributions

Dr Haiquan Chen is the guarantor of the manuscript. Dr Zongwei Chen: contributed to conception and study design, acquisition and analysis of data, and writing and revision of the manuscript. Dr Kanhua Yin: contributed to conception and study design, acquisition and analysis of data, and writing and revision of the manuscript. Dr Difan Zheng: contributed to conception and study design, acquisition and analysis of data, and writing and revision of the manuscript. Dr Jie Gu: contributed to acquisition of data and writing and revision of the manuscript. Dr Jizhuang Luo: contributed to acquisition of data and writing and revision of the manuscript. Dr Shuai Wang: contributed to acquisition of data and writing and revision of the manuscript. Dr Haiquan Chen: contributed to conception and study design, analysis of data, and review and revision of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent is waived as SEER is a de-identified, publicly available cancer database.

References

  1. Ikeda A, Kawachi I, Iso H, Iwasaki M, Inoue M, Tsugane S (2013) Social support and cancer incidence and mortality: the JPHC study cohort II. Cancer Causes Control 24(5):847–860CrossRefGoogle Scholar
  2. Jatoi A, Novotny P, Cassivi S et al (2007) Does marital status impact survival and quality of life in patients with non-small cell lung cancer? Observations from the mayo clinic lung cancer cohort. Oncologist 12(12):1456–1463CrossRefGoogle Scholar
  3. Konski AA, Pajak TF, Movsas B, Radiation Therapy Oncology Group et al (2006) Disadvantage of men living alone participating in Radiation Therapy Oncology Group head and neck trials. J Clin Oncol 24:4177–4183CrossRefGoogle Scholar
  4. Kravdal O (2001) The impact of marital status on cancer survival. Soc Sci Med 52(3):357–368CrossRefGoogle Scholar
  5. Kravdal O (2002) A cancer survival model that takes sociodemographic variations in “normal” mortality into account: comparison with other models. J Epidemiol Community Health 56:309–318CrossRefGoogle Scholar
  6. Ou SH, Ziogas A, Zell JA (2009) Prognostic factors for survival in extensive stage small cell lung cancer (ED-SCLC): the importance of smoking history, socioeconomic and marital statuses, and ethnicity. J Thorac Oncol 4(1):37–43CrossRefGoogle Scholar
  7. Parkin DM, Bray FJ, Ferlay L, Pissani P (2002) Global cancer statistics. CA Cancer J Clin 55:74–108CrossRefGoogle Scholar
  8. Saito-Nakaya K, Nakaya N, Fujimori M et al (2006) Marital status, social support and survival after curative resection in non-small-cell lung cancer. Cancer Sci 97(3):206–213CrossRefGoogle Scholar
  9. Saito-Nakaya K, Nakaya N, Akechi T et al (2008) Marital status and non-small cell lung cancer survival: the Lung Cancer Database Project in Japan. Psychooncology 17(9):869–876CrossRefGoogle Scholar
  10. Sculier JP, Chansky K, Crowley JJ, International Staging Committee and Participating Institutions et al (2008) The impact of additional prognostic factors on survival and their relationship with the anatomical extent of disease expressed by the 6th Edition of the TNM Classification of Malignant Tumors and the proposals for the 7th Edition. J Thorac Oncol 3:457–466CrossRefGoogle Scholar
  11. Siegel R, Naishadham D (2013) Jemal A (2013) Cancer statistics. CA Cancer J Clin 63(1):11–30CrossRefGoogle Scholar
  12. Tammemagi CM, Neslund-Dudas C, Simoff M et al (2004a) Smoking and lung cancer survival: the role of comorbidity and treatment. Chest 125:27–37CrossRefGoogle Scholar
  13. Tammemagi CM, Neslund-Dudas C, Simoff M et al (2004b) Lung carcinoma symptoms-an independent predictor of survival and an important mediator of African-American disparity in survival. Cancer 101:1655–1663CrossRefGoogle Scholar
  14. Tannenbaum SL, Zhao W, Koru-Sengul T et al (2013) Marital status and its effect on lung cancer survival. Springerplus 2:504CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Thoracic SurgeryFudan University Zhongshan HospitalShanghaiChina
  2. 2.Department of Cardiac SurgeryFudan University Zhongshan HospitalShanghaiChina
  3. 3.Department of Thoracic SurgeryFudan University Shanghai Cancer CenterShanghaiChina
  4. 4.Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina

Personalised recommendations