Marital status independently predicts prostate cancer survival in men who underwent radical prostatectomy: An analysis of 95,846 individuals

Huang,Tian‑Bao; Zhou,Guang‑Chen; Dong,Chuan‑Peng; Wang,Li‑Ping; Luan,Yang; Ye,Jing‑Ting; Gu,Xiao; Yao,Xu‑Dong; Zheng,Jun‑Hua; Ding,Xue‑Fei

doi:10.3892/ol.2018.7964

Marital status independently predicts prostate cancer survival in men who underwent radical prostatectomy: An analysis of 95,846 individuals

Authors:
- Tian‑Bao Huang
- Guang‑Chen Zhou
- Chuan‑Peng Dong
- Li‑Ping Wang
- Yang Luan
- Jing‑Ting Ye
- Xiao Gu
- Xu‑Dong Yao
- Jun‑Hua Zheng
- Xue‑Fei Ding
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Affiliations: Department of Urology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu 225001, P.R. China, Department of Biochemistry and Molecular Biology, Institute of Biomedical Science, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China, Department of Biobank, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu 225001, P.R. China, Department of Cardiothoracic Surgery, College of Clinical Medicine, Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China, Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, P.R. China
Published online on: February 6, 2018 https://doi.org/10.3892/ol.2018.7964
Pages: 4737-4744
Copyright: © Huang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Marital status is an independent prognostic factor for survival in several types of cancer, but has not been fully studied in prostate cancer (PCa). A total of 95,846 men diagnosed with PCa were treated with radical prostatectomy (RP) between 2004 and 2009 within 18 Surveillance, Epidemiology and End Results registries. Survival curves were generated using Kaplan‑Meier estimates and differences in survival were assessed using the log‑rank test. Cox regression models were used to assess the impact of marital status on survival outcomes. The results demonstrated that the 8‑year cancer‑cause specific survival (CSS) rate of married men was higher than unmarried individuals. Further analyses revealed that divorced/separated men had a higher proportion of high Gleason scores (GS) PCa at diagnosis [hazard ratio (HR), 1.12; P=0.007] and those patients had the worst survival outcomes independent of age, ethnicity, grade, stage and sequence number [HR, 1.61; 95% confidence interval (CI), 1.34‑1.93]. Interestingly, it was observed that CSS among divorced/separated men decreased as the GS increased (GS≤6: HR, 2.5; GS=7: HR, 1.71; GS≥8: HR, 1.50; all P<0.05). Apart from that, no significant differences in CSS were observed in those who had never been married (HR, 1.20) or were widowed (HR, 1.13) relative to the married group. The results of the present study support the hypothesis that marital status is an independent prognostic factor among men with PCa who underwent RP. It was demonstrated that the mortality rates of divorced or separated men with PCa were significantly greater compared with the other groups. A further understanding of the potential associations among marital status, psychosocial factors and survival outcomes may help in developing novel, more effective methods of treating different groups of patients with PCa.

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