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Marital Status and Survival in Patients with Carcinoid Tumors

机译:类癌肿瘤患者的婚姻状况和生存

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Background Marital status is a known prognostic factor in overall and disease-specific survival in several types of cancer. The impact of marital status on survival in patients with carcinoid tumors remains unknown. We hypothesized that married patients have higher rates of survival than similar unmarried patients with carcinoid tumors.Methods Using the Surveillance, Epidemiology, and End Results database, we identified 23,126 people diagnosed with a carcinoid tumor between 2000 and 2011 and stratified them according to marital status. Univariate and multivariable analyses were performed to compare the characteristics and outcomes between patient cohorts. Overall and cancer-related survival were analyzed using the Kaplan–Meier method. Multivariable survival analyses were performed using Cox proportional hazards models (hazards ratio [HR]), controlling for demographics and tumor-related and treatment-related variables. Propensity score analysis was performed to determine surgical intervention distributions among married and unmarried (ie, single, separated, divorced, widowed) patients.Results Marital status was significantly related to both overall and cancer-related survival in patients with carcinoid tumors. Divorced and widowed patients had worse overall survival (HR, 1.33 [95% confidence interval {CI}, 1.08–1.33] and 1.34 [95% CI, 1.22–1.46], respectively) and cancer-related survival (HR, 1.15 [95% CI, 1.00–1.31] and 1.15 [95% CI, 1.03–1.29], respectively) than married patients over five years. Single and separated patients had worse overall survival (HR, 1.20 [95% CI, 1.08–1.33] and 1.62 [95% CI, 1.25–2.11], respectively) than married patients over five years, but not worse cancer-related survival. Unmarried patients were more likely than matched married patients to undergo definitive surgical intervention (62.67% vs 53.11%, respectively, P < 0.0001).Conclusions Even after controlling for other prognostic factors, married patients have a survival advantage after diagnosis of any carcinoid tumor, potentially reflecting better social support and financial means than patients without partners.
机译:背景婚姻状况是几种类型癌症总体和疾病特异性生存的已知预后因素。婚姻状况对类癌肿瘤患者生存的影响仍然未知。我们假设已婚患者比未婚的类癌患者具有更高的生存率。方法使用监测,流行病学和最终结果数据库,我们在2000年至2011年间确定了23126名被诊断为类癌的人,并根据婚姻状况对其进行了分层。进行单变量和多变量分析以比较患者队列之间的特征和结果。使用Kaplan-Meier方法分析了总生存期和癌症相关生存期。使用Cox比例风险模型(风险比[HR])进行多变量生存分析,控制人口统计学以及与肿瘤相关和与治疗相关的变量。倾向得分分析用于确定已婚和未婚(即单身,分居,离婚,丧偶)患者之间的手术干预分布。结果婚姻状况与类癌患者的总体生存和癌症相关生存率均显着相关。离婚和丧偶的患者的总生存期较差(HR,1.33 [95%置信区间{CI},1.08–1.33]和1.34 [95%CI,1.22-1.46],癌症相关的生存率(HR,1.15 [95]) %CI,1.00–1.31]和1.15 [95%CI,1.03–1.29],分别高于已婚患者五年。与已婚患者相比,单身和分离患者的五年总生存率较差(HR为1.20 [95%CI,1.08–1.33]和1.62 [95%CI,1.25-2.11]),但与癌症相关的生存率却没有恶化。未婚患者比配对的患者更有可能接受明确的手术干预(分别为62.67%和53.11%,P <0.0001)。与没有伴侣的患者相比,可能反映出更好的社会支持和财务手段。

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