Dataset Information

Impact of Marital Status on Tumor Stage at Diagnosis and on Survival in Male Breast Cancer.

ABSTRACT: The effect of marital status (MS) on survival varies according to cancer type and gender. There has been no report on the impact of MS on survival in male breast cancer (MBC). This study aims to determine the influence of MS on tumor stage at diagnosis and survival in MBC. Men with MBC ?18 years of age in the SEER database from 1990 to 2011 were included in the study. MS was classified as married and unmarried (including single, divorced, separated, widowed). Kaplan-Meier method was used to estimate the 5-year cancer-specific survival. Multivariate regression analyses were done to determine the effect of MS on presence of Stage IV disease at diagnosis and on cancer-specific mortality. The study included 3,761 men; 2,647 (70.4%) were married. Unmarried men were more often diagnosed with Stage IV MBC compared with married (10.7% vs. 5.5%, p < .001). Unmarried men (compared with married) were significantly less likely to undergo surgery (92.4% vs. 96.7%, p < .001). Overall unmarried males with Stages II, III, and IV MBC have significantly worse 5-year cancer-specific survival compared with married. On multivariate analysis, being unmarried was associated with increased hazard of death (HR = 1.43, p < .001) and increased likelihood of Stage IV disease at diagnosis ( OR = 1.96, p < .001). Unmarried males with breast cancer are at greater risk for Stage IV disease at diagnosis and poorer outcomes compared with married males.

SUBMITTER: Adekolujo OS

PROVIDER: S-EPMC5675311 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Impact of Marital Status on Tumor Stage at Diagnosis and on Survival in Male Breast Cancer.

Adekolujo Orimisan Samuel OS Tadisina Shourya S Koduru Ujwala U Gernand Jill J Smith Susan Jane SJ Kakarala Radhika Ramani RR

American journal of men's health 20160929 4

The effect of marital status (MS) on survival varies according to cancer type and gender. There has been no report on the impact of MS on survival in male breast cancer (MBC). This study aims to determine the influence of MS on tumor stage at diagnosis and survival in MBC. Men with MBC ≥18 years of age in the SEER database from 1990 to 2011 were included in the study. MS was classified as married and unmarried (including single, divorced, separated, widowed). Kaplan-Meier method was used to esti ...[more]

PMID: 27694551

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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.

Project description:Importance:Circulating tumor cells (CTCs) represent the liquid component of solid tumors and are a surrogate marker for residual cancer burden. Although CTC status is prognostic of recurrence and death in breast cancer, its role in guiding clinical management remains unknown. Objective:To determine whether CTC status is predictive of radiotherapeutic benefit in early-stage breast cancer. Design, Setting, and Participants:The cohort studies in the present analysis included patients with stages pT1 to pT2 and pN0 to pN1 breast cancer and known CTC status from the National Cancer Database (NCDB) and the multicenter phase 3 SUCCESS clinical trial. Multivariable parametric accelerated failure time models were used to evaluate the association of CTC status and radiotherapy (RT) with survival outcomes. Data were collected from January 1, 2004, through December 31, 2014, from the NCDB cohort. The SUCCESS trial collected data from September 1, 2005, through September 30, 2013. The analyses were completed from November 1, 2016, through December 17, 2017. Exposure:Adjuvant RT. Main Outcomes and Measures:Overall survival (OS), local recurrence-free survival (LRFS), and disease-free survival (DFS). Results:A total of 1697 patients from the NCDB (16 men [0.9%] and 1681 women [99.1%]; median age, 63 years; interquartile range, 53-71 years) and 1516 patients from the SUCCESS clinical trial (median age, 52 years; interquartile range, 45-60 years) were identified. Circulating tumor cells were detected in 399 patients (23.5%) in the NCDB cohort and 294 (19.4%) in the SUCCESS cohort. The association of RT with survival was dependent on CTC status within the NCDB cohort (4-year OS, 94.9% for CTC-positive RT vs 88.0% for CTC-positive non-RT vs 93.9% for CTC-negative RT vs 93.4% for CTC-negative non-RT groups; P < .001) and 5-year DFS within the SUCCESS cohort (88.0% for CTC-positive RT vs 75.2% for CTC-positive non-RT vs 92.3% for CTC-negative RT vs 88.3% for CTC-negative non-RT; P = .04). In the NCDB cohort, RT was associated with longer OS in patients with CTCs (time ratio [TR], 2.04; 95% CI, 1.55-2.67; P < .001), but not in patients without CTCs (TR, 0.80; 95% CI, 0.52-1.25; P = .33). In the SUCCESS cohort, CTC-positive patients treated with RT exhibited longer LRFS (TR, 2.73; 95% CI, 1.62-4.80; P < .001), DFS (TR, 3.03; 95% CI, 2.22-4.13; P < .001), and OS (TR, 1.83; 95% CI, 1.23-2.72; P = .003). Among patients from both cohorts who underwent breast-conserving surgery, RT was associated with longer OS in patients with CTCs (TR, 4.37; 95% CI, 2.71-7.05; P < .001) but not in patients without CTCs (TR, 0.87; 95% CI, 0.47-1.62; P = .77). Radiotherapy was not associated with OS after mastectomy in CTC-positive or CTC-negative patients. Conclusions and Relevance:Treatment with RT was associated with longer LRFS, DFS, and OS in patients with early-stage breast cancer and detectable CTCs. These results are hypothesis generating; a prospective trial evaluating CTC-based management for RT after breast-conserving surgery in women with early-stage breast cancer is warranted.

Dataset Information

Impact of Marital Status on Tumor Stage at Diagnosis and on Survival in Male Breast Cancer.

Publications

Impact of Marital Status on Tumor Stage at Diagnosis and on Survival in Male Breast Cancer.

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