Effect of marital status on the survival of patients with hepatocellular carcinoma treated with surgical resection: an analysis of 13,408 patients in the surveillance, epidemiology, and end results (SEER) database

Abstract

Marital status has been reported as an independent prognostic factor for survival in various cancers, but it has been rarely studied in hepatocellular carcinoma (HCC) treated by surgical resection. We retrospectively investigated Surveillance, Epidemiology, and End Results (SEER) population-based data and identified 13,408 cases of HCC with surgical treatment between 1998 and 2013. The patients were categorized according to marital status, as “married,” “never married,” “widowed,” or “divorced/separated.” The 5-year HCC cause-specific survival (HCSS) data were obtained, and Kaplan–Meier methods and multivariate Cox regression models were used to ascertain whether marital status is also an independent prognostic factor for survival in HCC. Patients in the widowed group had the higher proportion of women, a greater proportion of older (>60 years) patients, more frequency in latest year of diagnosis (2008-2013), a greater number of tumors at TNM stage I/II, and more prevalence at localized SEER Stage, all of which were statistically significant within-group comparisons (P < 0.001). Marital status was demonstrated to be an independent prognostic factor by multivariate survival analysis (P < 0.001). Married patients had better 5-year HCSS than did unmarried patients (46.7% vs 37.8%) (P < 0.001); conversely, widowed patients had lowest HCSS compared with all other patients, overall, at each SEER stage, and for different tumor sizes. Marital status is an important prognostic factor for survival in patients with HCC treated with surgical resection. Widowed patients have the highest risk of death compared with other groups.

Marital status and survival in epithelial ovarian cancer patients: a SEER-based study

“…Though most of the findings of this study are consistent with the findings of previous observational studies conducted on other types of cancer [ 8 , 12 , 17 , 18 ], that unmarried patients had survival disadvantage compared with married patients, the significance of this study is that we analyzed the effect of marital status on the OS and EOCSS according to different stages and repeated the analyses for patients who underwent surgery, which had never been investigated for ovarian cancer before.…”

The influence of marital status on survival in patients with oral tongue squamous cell carcinoma

“…In addition, it pointed out that the widowed patients always endured the highest risk of mortality for OS and TCSS. The meaning of this study lies in the important impact of marital status on survival of oral tongue squamous cell carcinoma, which is in consistency with previous researches of other cancers [ 17 – 20 ].…”

Effects of marital status on survival of hepatocellular carcinoma by race/ethnicity and gender

“…Previously published articles also indicated that marital status was considered as a prognostic factor of better survival in liver cancer. 19 , 20 Less well investigated, however, is the influence of race/ethnicity and gender in the association between being married and overall prognosis of HCC. Therefore, we performed a population-based study to fill the gap on racial and gender differences in marriage-associated survival benefits,…”