title: Influence of marital status on the survival of patients with gastric cancer.
abstract: OBJECTIVE
  The influence of marital status on gastric cancer (GC) survival is controversial. The aim of our study was to investigate the relationship between marital status and the survival of GC patients.
  
  
  METHODS
  The data of current study was from the Surveillance, Epidemiology, and End-Results database. We identified 18,815 GC patients between 2004 and 2009, who were categorized into married, never married, widowed, and divorced/separated groups. Kaplan-Meier analysis was performed to compare gastric cancer specific survival (GCSS), and Cox regression analysis was used to estimate the risk factors for different survival outcomes in four groups with diverse marital status.
  
  
  RESULTS
  Married patients had better 5-year GCSS compared with patients who were never married, separated/widowed, or divorced. In stratified analyses by histological type and pathological differentiation, unmarried patients with gastric adenocarcinoma, signet ring cell carcinoma, moderately differentiated caicinoma, and poorly differentiated/undifferentiated carcinoma had an increased risk of cancer mortality. Widowed patients had the highest percentage of women and elderly, and were more susceptible to well and moderately differentiated gastric carcinomars and gastric adenocarcinoma with earlier TNM stage and lowest rate of surgery and radiation therapy. In addition, they also had the worst 5-year GCSS.
  
  
  CONCLUSIONS
  Our study suggests that unmarried GC patients, especially widowed patients, are at a high risk of GCSS. Additionally, the survival benefit is more significant among married GC patients in higher malignancy status.
authors.affiliation: Department of General Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.
authors.forename: Rongping
authors.initials: R
authors.lastname: Zhou
authors.affiliation: Department of Hepatobiliary Surgery, The Traditional Chinese Medicine Hospital of Weifang, Weifang, Shandong Province, China.
authors.forename: Shushan
authors.initials: S
authors.lastname: Yan
authors.affiliation: Department of General Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Li
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000523:psychology / Q000628:therapy; D000368:Aged; D002277:Carcinoma / Q000401:mortality* / Q000473:pathology / Q000523:psychology / Q000628:therapy; D018279:Carcinoma, Signet Ring Cell / Q000401:mortality* / Q000473:pathology / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012306:Risk; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D015996:Survival Rate; D017805:Widowhood / Q000523:psychology / Q000706:statistics & numerical data
keywords: gastric cancer; histological type; marital status; pathological differentiation; survival