title: Marital status and survival in pancreatic cancer patients: a SEER based analysis.
abstract: BACKGROUND
  Recent findings suggest that marital status affects survival in patients with different types of cancer. However, its role in the survival of patients with pancreatic ductal adenocarcinoma is unknown. In this study, we investigated whether there was an association between marital status and overall survival (OS) in patients with pancreatic ductal adenocarcinoma (PDAC).
  
  
  METHODS
  Adult patients diagnosed with PDAC between 1998 and 2003 with known marital statuses were identified from the Surveillance, Epidemiology, and End Results registry of the National Cancer Institute. OS for these patients was plotted using the Kaplan-Meier method. Comparative risks of mortality were evaluated by using univariate and multivariate-adjusted Cox regression models.
  
  
  RESULTS
  Using Kaplan-Meier analysis, we found that the median overall survival of patients was 4 months and 3 months (p<0.001) for married and unmarried patients, respectively. Subgroup analysis on patients with cancer-directed surgery showed that the median survival was 16 months and 13 months (P<0.0005) for married and unmarried groups, respectively. Multivariate analysis adjusting for age, race, sex, stage, year of diagnosis, radiation therapy and cancer-directed surgery showed that patients who were married at the time of diagnosis had a significantly decreased risk of death at both 2 months (15% risk reduction) and 3 years (13% risk reduction) post diagnosis.
  
  
  CONCLUSIONS
  Marital status is an independent prognostic factor of both perioperative and long-term survival in patients with PDAC. This observation may suggest a suboptimally met psychosocial need among PDAC patients that is partially fulfilled by the support system provided by marriage.
authors.affiliation: Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, Nebraska, United States of America.
authors.forename: Michael
authors.initials: M
authors.lastname: Baine
authors.forename: Freshta
authors.initials: F
authors.lastname: Sahak
authors.forename: Chi
authors.initials: C
authors.lastname: Lin
authors.forename: Subhankar
authors.initials: S
authors.lastname: Chakraborty
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lyden
authors.forename: Surinder K
authors.initials: SK
authors.lastname: Batra
mesh_terms: D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008393:Marriage; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality*; D018426:SEER Program; D016019:Survival Analysis