Effect of Marital Status on the Survival of Patients With Adenocarcinoma of the Esophagogastric Junction: A Population-Based, Propensity-Matched Study

Sihan Wang; Liubo Chen; Dongdong Chen; Jian Chao; Yangliu Shao; Kejun Tang; Wenteng Chen

doi:10.1177/10732748211066309

Effect of Marital Status on the Survival of Patients With Adenocarcinoma of the Esophagogastric Junction: A Population-Based, Propensity-Matched Study

Cancer Control. 2021 Jan-Dec:28:10732748211066309. doi: 10.1177/10732748211066309.

Authors

Sihan Wang¹, Liubo Chen², Dongdong Chen¹, Jian Chao³, Yangliu Shao⁴, Kejun Tang⁵, Wenteng Chen⁶

Affiliations

¹ Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences), the Second Affiliated Hospital, 89681Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
² Department of Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, the Second Affiliated Hospital, 89681Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
³ Department of Electrocardigram, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China.
⁴ Department of Hematology, 104607Chinese PLA General Hospital, Beijing, China.
⁵ Department of Surgery, Women's Hospital, School of Medicine, 89681Zhejiang University, Hangzhou, Zhejiang, China.
⁶ College of Pharmaceutical Sciences, 366096Zhejiang University, Hangzhou, Zhejiang, China.

Abstract

Background: Marital status has been reported as an independent prognostic factor in various types of malignancies. However, the association between marital status and outcomes of patients with adenocarcinoma of the esophagogastric junction (AEG) has not been fully explored. To this end, we aimed to investigate the effect of marital status on survival of AGE patients.

Methods: The Surveillance Epidemiology and End Results (SEER) database (2010-2015) was used to extract eligible patients with Siewert type II AEG. Meanwhile, propensity score matching was performed to match 1576 unmarried patients with 1576 married patients. Kaplan-Meier method with log-rank test was used to plot survival curves, univariate and multivariate Cox regression analyses were adopted to investigate the association of marital status with overall survival (OS) and cancer-specific survival (CSS) in AEG patients before and after matching.

Results: Multivariate analysis in the unmatched cohort revealed that marital status was an independent prognostic factor in patients with Siewert type II AEG. Unmarried patients had poorer OS (hazard ratio [HR]: 1.22, 95% confidence interval [CI]: 1.12-1.29, P < .001) and poorer CSS (HR: 1.19, 95% CI: 1.10-1.29, P < .001) than married patients before matching. Additionally, widowed patients had the poorest OS (HR: 1.26, 95% CI: 1.11-1.44, P < .001) and CSS (HR: 1.29, 95% CI: 1.12-1.48, P < .001) compared with married patients. Furthermore, unmarried status remained as an independent prognostic for both OS (HR: 1.20, 95% CI: 1.10-1.31, P < .001) and CSS (HR: 1.18, 95% CI: 1.08-1.30, P < .001) in 1:1 propensity score-matched analysis. Subgroup analysis further revealed that OS and CSS rates were significantly higher in married patients than unmarried ones in most subgroups stratified by different variables.

Conclusions: This population-based study identified that marital status was an independent prognostic indicator for AEG patients. Married AEG patients had better prognosis than their unmarried counterparts.

Keywords: SEER; adenocarcinoma of the esophagogastric junction; marital status; prognosis.

MeSH terms

Adenocarcinoma / mortality*
Aged
Esophageal Neoplasms / mortality*
Esophagogastric Junction
Female
Humans
Kaplan-Meier Estimate
Male
Marital Status / statistics & numerical data*
Middle Aged
Multivariate Analysis
Prognosis
Propensity Score
Proportional Hazards Models
Risk Factors
SEER Program
Survival Rate