title: Marital status and survival after oesophageal cancer surgery: a population-based nationwide cohort study in Sweden.
abstract: OBJECTIVE
  A beneficial effect of being married on survival has been shown for several cancer types, but is unclear for oesophageal cancer. The objective of this study was to clarify the potential influence of the marital status on the overall and disease-specific survival after curatively intended treatment of oesophageal cancer using a nationwide population-based design, taking into account the known major prognostic variables.
  
  
  METHODS
  Prospective, population-based cohort.
  
  
  METHODS
  All Swedish hospitals performing surgery for oesophageal cancer during 2001-2005.
  
  
  METHODS
  This study included 90% of all patients with oesophageal or junctional cancer who underwent surgical resection in Sweden in 2001-2005, with follow-up until death or the end of the study period (2012).
  
  
  METHODS
  Cox regression was used to estimate associations between the marital status and the 5-year overall and disease-specific mortality, expressed as HRs with 95% CIs, with adjustment for sex, age, tumour stage, histological type, complications, comorbidities and annual surgeon volume.
  
  
  RESULTS
  Of all 606 included patients (80.4% men), 55.1% were married, 9.2% were remarried, 22.6% were previously married and 13% were never married. Compared with the married patients, the never married (HR 1.02, 95% CI 0.77 to 1.35), previously married (HR 0.90, 95% CI 0.71 to 1.15) and remarried patients (HR 0.79, 95% CI 0.55 to 1.13) had no increased overall 5-year mortality. The corresponding HRs for disease-specific survival, and after excluding the initial 90 days of surgery, were similar to the HRs for the overall survival.
  
  
  CONCLUSIONS
  This study showed no evidence of a better 5-year survival in married patients compared with non-married patients undergoing surgery for oesophageal cancer.
authors.affiliation: Unit of Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Nele
authors.identifier: http://orcid.org/0000-0003-0137-447X
authors.initials: N
authors.lastname: Brusselaers
authors.affiliation: Unit of Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Mattsson
authors.affiliation: Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Asif
authors.initials: A
authors.lastname: Johar
authors.affiliation: Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Wikman
authors.affiliation: Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Pernilla
authors.initials: P
authors.lastname: Lagergren
authors.affiliation: Unit of Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden Division of Cancer Studies, King's College London, London, UK.
authors.forename: Jesper
authors.initials: J
authors.lastname: Lagergren
authors.affiliation: Unit of Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Rickard
authors.initials: R
authors.lastname: Ljung
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D015996:Survival Rate; D013548:Sweden
keywords: Marital Status; Oesophageal Cancer; Survival