The impact of marital status at diagnosis on cancer survival in patients with differentiated thyroid cancer.
Previous studies have revealed that marital status influences the prognosis of patients with various types of cancer. We evaluated the influence of marriage on the survival outcomes in differentiated thyroid cancer (DTC). The Surveillance, Epidemiology and End Results (SEER) database between 2002 and 2012 was used to compare cancer-specific mortality in different marital status, and in each sex, age, and stage stratification by multivariate Cox regression model. In total, 61,077 eligible patients were identified. The widowed group had the highest proportion of women, elderly patients (≥45 years), and advanced stage III/IV tumor (P = 0.001), but the total thyroidectomy (TT) performed and radioisotopes therapy rates were lower than those in the married group. Married patients had a better cancer-specific survival (CSS) than the unmarried (P < 0.05). Further analysis showed that widowed patients always presented the lowest CSS compared with other groups. Widowed patients had a significant increased risk for CSS compared with married patients in males [hazard ratio (HR) 2.72, 95% confidence interval (CI): 1.59-4.65, P = 0.001], females (HR 2.02, 95% CI: 2.24-4.06, P = 0.001), young patients (<45, HR 28.12, 95% CI: 3.48-227.25, P = 0.002), elderly patients (≥45, HR 28.12, 95% CI: 2.97, 95% CI: 2.30-3.83, P = 0.001), stage I (HR 8.44, 95% CI: 4.05-17.59, P = 0.001), stage II (HR 3.64, 95% CI: 1.30-10.20, P = 0.014), stage III (HR 2.27, 95% CI: 1.08-4.78, P = 0.031), and stage IV (HR 2.63, 95% CI: 1.94-3.57, P = 0.001). These results showed that unmarried status, especially for widowhood, increased the risk of cancer mortality in DTC patients.
Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.|Department of General Surgery, Minhang Hospital, Fudan University, Shanghai, 201199, China.
Rong-Liang
RL
Shi
Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
Ning
N
Qu
Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
Zhong-Wu
ZW
Lu
Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
Tian
T
Liao
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.|Department of Ultrasonography, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Yi
Y
Gao
Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
Qing-Hai
QH
Ji
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D017533:Marital Status; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011159:Population Surveillance; D018426:SEER Program; D016019:Survival Analysis; D013964:Thyroid Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D014481:United States / Q000453:epidemiology / Q000208:ethnology
Differentiated thyroid cancer; SEER; marital status; survival analysis