Dataset Information

Marital status and survival after oesophageal cancer surgery: a population-based nationwide cohort study in Sweden.

ABSTRACT:

Objectives

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.

Design

Prospective, population-based cohort.

Setting

All Swedish hospitals performing surgery for oesophageal cancer during 2001-2005.

Participants

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).

Primary and secondary outcome measures

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.

SUBMITTER: Brusselaers N

PROVIDER: S-EPMC4054621 | biostudies-literature | 2014 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Marital status and survival after oesophageal cancer surgery: a population-based nationwide cohort study in Sweden.

Brusselaers Nele N Mattsson Fredrik F Johar Asif A Wikman Anna A Lagergren Pernilla P Lagergren Jesper J Ljung Rickard R

BMJ open 20140606 6

<h4>Objectives</h4>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.<h4>Design</h4>Prospective, population-based cohort.<h4>Set ...[more]

PMID: 24907248

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Project description:BACKGROUND:The importance of socioeconomic status for survival in cirrhosis patients is more or less pronounced within different populations, most likely due to cultural and regional differences combined with dissimilarities in healthcare system organisation and accessibility. Our aim was to study the survival of patients with cirrhosis in a population-based Swedish cohort, using available data on marital status, employment status, and occupational skill level. METHODS:We conducted a retrospective cohort study of 582 patients diagnosed with cirrhosis in the Region of Halland (total population 310,000) between 2011 and 2018. Medical and histopathologic data, obtained from registries, were reviewed. Cox regression models were used to estimate associations between survival and marital status (married, never married, previously married), employment status (employed, pensioner, disability retired, unemployed), and occupational skill level (low-skilled: level I; medium-skilled: level II; medium-high skilled: level III; professionals: level IV); adjusting for sex, age, aetiology, Model for End-stage Liver Disease (MELD) score, Child-Pugh class, and comorbidities. RESULTS:Alcohol was the most common aetiology (51%). Most patients were male (63%) and the median age was 66?years. Occupational skill level was associated with the severity of cirrhosis at diagnosis and the prevalence of Child-Pugh C gradually increased from professionals through low-skilled. The mean survival for professionals (6.39?years, 95% CI 5.54-7.23) was higher than for low-skilled (3.00?years, 95% CI 2.33-3.67) and medium-skilled (4.04?years, 95% CI 3.64-4.45). The calculated hazard ratios in the multivariate analysis were higher for low-skilled (3.43, 95% CI 1.89-6.23) and medium-skilled (2.48, 95% CI 1.48-4.12), compared to professionals. When aggregated, low- and medium-skilled groups also had poorer mean survival (3.79?years, 95% CI 3.44-4.14; vs 5.64?years, 95% CI 5.00-6.28) and higher hazard ratios (1.85, 95% CI 1.32-2.61) compared to the aggregated medium-high skilled and professional groups. Marital and employment status were not statistically significant predictors of mortality in the multivariate analysis. CONCLUSIONS:Occupational skill level was strongly associated with mean survival and mortality risk. Poorer prognosis among patients with low and medium occupational skill level could not be explained by differences in sex, age, marital status, employment status, MELD score, Child-Pugh class, or comorbidity.

Project description:Marital status proved to be an independent prognostic factor for survival in patients with breast cancer. We therefore strove to explore the impact of dynamic changes in marital status on the prognosis of breast cancer patients. We selected patients meeting the eligibility criteria from the Surveillance, Epidemiology, and End Results cancer database. We then used multivariate Cox proportional hazard regression model to analyze the effect of dynamic changes in marital status on the prognosis of overall survival (OS) and breast cancer-specific special survival (BCSS). Compared with the patients in the Single-Single group and the divorced/separated/widowed-divorced/separated/widowed (DSW-DSW) group, patients in the Married-Married group were significantly associated with better BCSS (HR 1.13, 95% CI: 1.03-1.19, P < 0.001; HR 1.19, 95% CI: 1.14-1.25, P < 0.001, respectively) and OS (HR 1.25, 95% CI: 1.20-1.30, P < 0.001; HR 1.49, 95% CI: 1.45-1.54, P < 0.001, respectively). In contrast to the DSW-DSW group, the Single-Single group and the DSW-Married group showed similar BCSS (HR 0.98, 95% CI: 0.92-1.05, P = 0.660; HR 1.06, 95% CI: 0.97-1.15, P = 0.193, respectively) but better OS (HR 1.14, 95% CI: 1.09-1.19, P < 0.001; HR 1.32, 95% CI: 1.25-1.40, P < 0.001, respectively). Compared with the Single-Single group, the Single-Married group showed significantly better BCSS (HR 1.21, 95% CI: 1.07-1.36, P = 0.003) but no difference in OS (HR 1.08, 95% CI: 0.98-1.18, P = 0.102); In contrast to the Married-DSW group, the Married-Married group exhibited better BCSS (HR 1.11, 95% CI: 1.05-1.18, P < 0.001) and OS (HR 1.27, 95% CI: 1.22-1.32, P < 0.001). Our study demonstrated that, regardless of their previous marital status, married patients had a better prognosis than unmarried patients. Moreover, single patients obtained better survival outcomes than DSW patients. Therefore, it is necessary to proactively provide single and DSW individuals with appropriate social and psychological support that would benefit them.

Dataset Information

Marital status and survival after oesophageal cancer surgery: a population-based nationwide cohort study in Sweden.

Objectives

Design

Setting

Participants

Primary and secondary outcome measures

Results

Conclusions

Publications

Marital status and survival after oesophageal cancer surgery: a population-based nationwide cohort study in Sweden.

Similar Datasets

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