title: A population-based analysis of the effect of marital status on overall and cancer-specific mortality in patients with squamous cell carcinoma of the penis.
abstract: OBJECTIVE
  The association between marital status and tumor stage and grade, as well as overall mortality (OM) and cancer-specific mortality (CSM) received little attention in patients with squamous cell carcinoma of the penis (SCCP).
  
  
  METHODS
  We relied on the surveillance, epidemiology, and end results (SEER) 17 database to identify patients diagnosed with primary SCCP. Logistic and Cox regression models, respectively, addressed the effect of marital status on the rate of locally advanced disease and its effect on OM and CSM. Covariates consisted of age, race, socioeconomic status, year of surgery, and SEER registries.
  
  
  RESULTS
  Between 1988 and 2006, 1,884 patients with SCCP were identified. At surgery, 1,192 (63.3 %) were married and 966 (51.3 %) had locally advanced disease. In multivariable logistic regression models predicting locally advanced disease at surgery, unmarried men had a 1.5-fold higher (p < 0.001) risk than others. In multivariable Cox models predicting CSM, marital status had no effect [hazard ratio (HR) = 1.3, p = 0.1]. Finally, in multivariable Cox models predicting OM, unmarried men had a 1.3-fold higher (p = 0.001) risk than others.
  
  
  CONCLUSIONS
  Unmarried men tend to present with less favorable disease stage at SCCP. Moreover, unmarried men tend to live less long than their married counterparts. However, marital status has no effect on CSM.
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, QC, Canada. rodolphethuret@gmail.com
authors.forename: Rodolphe
authors.initials: R
authors.lastname: Thuret
authors.forename: Maxine
authors.initials: M
authors.lastname: Sun
authors.forename: Lars
authors.initials: L
authors.lastname: Budaus
authors.forename: Firas
authors.initials: F
authors.lastname: Abdollah
authors.forename: Daniel
authors.initials: D
authors.lastname: Liberman
authors.forename: Shahrokh F
authors.initials: SF
authors.lastname: Shariat
authors.forename: François
authors.initials: F
authors.lastname: Iborra
authors.forename: Jacques
authors.initials: J
authors.lastname: Guiter
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Patard
authors.forename: Paul
authors.initials: P
authors.lastname: Perrotte
authors.forename: Pierre I
authors.initials: PI
authors.lastname: Karakiewicz
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000401:mortality*; D002423:Cause of Death; D006801:Humans; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data*; D008875:Middle Aged; D010412:Penile Neoplasms / Q000453:epidemiology* / Q000401:mortality*; D010413:Penis / Q000473:pathology; D011153:Population; D018426:SEER Program / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology