TY - JOUR
T1 - The effect of marital status on stage and survival of prostate cancer patients treated with radical prostatectomy
T2 - A population-based study
AU - Abdollah, Firas
AU - Sun, Maxine
AU - Thuret, Rodolphe
AU - Abdo, Al'a
AU - Morgan, Monica
AU - Jeldres, Claudio
AU - Shariat, Shahrokh F.
AU - Perrotte, Paul
AU - Montorsi, Francesco
AU - Karakiewicz, Pierre I.
N1 - Funding Information:
Acknowledgments Pierre I. Karakiewicz is partially supported by the University of Montreal Health Center Fonds de la Recherche en Santé du Quebec, the University of Montreal Department of Surgery and the University of Montreal Health Center (CHUM) Foundation.
PY - 2011/8
Y1 - 2011/8
N2 - Objective: The detrimental effect of unmarried marital status on stage and survival has been confirmed in several malignancies. We set to test whether this applied to patients diagnosed with prostate cancer (PCa) treated with radical prostatectomy (RP). Methods: We identified 163,697 non-metastatic PCa patients treated with RP, within 17 Surveillance, Epidemiology, and End Results registries. Logistic regression analyses focused on the rate of locally advanced stage (pT3-4/pN1) at RP. Cox regression analyses tested the relationship between marital status and cancer-specific (CSM), as well as all-cause mortality (ACM). Results: Respectively, 9.1 and 7.8% of individuals were separated/divorced/widowed (SDW) and never married. SDW men had more advanced stage at surgery (odds ratio: 1.1; p<0.001), higher CSM and ACM (both hazard ratio [HR]: 1.3; p<0.001) than married men. Similarly, never married marital status portended to a higher ACM rate (HR:1.2, p = 0.001). These findings were consistent when analyses were stratified according to organ confined vs. locally advanced stages. Conclusions: Being SDW significantly increased the risk of more advanced stage at RP. Following surgery, SDW men portended to a higher CSM and ACM rate than married men. Consequently, these individuals may benefit from a more focused health care throughout the natural history of their disease.
AB - Objective: The detrimental effect of unmarried marital status on stage and survival has been confirmed in several malignancies. We set to test whether this applied to patients diagnosed with prostate cancer (PCa) treated with radical prostatectomy (RP). Methods: We identified 163,697 non-metastatic PCa patients treated with RP, within 17 Surveillance, Epidemiology, and End Results registries. Logistic regression analyses focused on the rate of locally advanced stage (pT3-4/pN1) at RP. Cox regression analyses tested the relationship between marital status and cancer-specific (CSM), as well as all-cause mortality (ACM). Results: Respectively, 9.1 and 7.8% of individuals were separated/divorced/widowed (SDW) and never married. SDW men had more advanced stage at surgery (odds ratio: 1.1; p<0.001), higher CSM and ACM (both hazard ratio [HR]: 1.3; p<0.001) than married men. Similarly, never married marital status portended to a higher ACM rate (HR:1.2, p = 0.001). These findings were consistent when analyses were stratified according to organ confined vs. locally advanced stages. Conclusions: Being SDW significantly increased the risk of more advanced stage at RP. Following surgery, SDW men portended to a higher CSM and ACM rate than married men. Consequently, these individuals may benefit from a more focused health care throughout the natural history of their disease.
KW - Marital status
KW - Neoplasm staging
KW - Prostatic neoplasms/epidemiology
KW - SEER program
KW - Survival rates/trends
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U2 - 10.1007/s10552-011-9784-x
DO - 10.1007/s10552-011-9784-x
M3 - Article
C2 - 21643929
AN - SCOPUS:82955237276
SN - 0957-5243
VL - 22
SP - 1085
EP - 1095
JO - Cancer Causes and Control
JF - Cancer Causes and Control
IS - 8
ER -