Marital status and survival in patients with gastric cancer

Jin, Jie; Wang, Wei; Dai, Fa Xiang; Long, Zi; Cai, Hong; Liu, Xiao Wen; Zhou, Ye; Huang, Hua; Wang, Ya Nong

doi:10.1002/cam4.758

Cited by 56 publications

(43 citation statements)

References 43 publications

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“…This is in line with previous SEER analyses for pancreatic cancer patients[14] as well as for many other solid tumors[15,16]. Moreover, the current analysis showed an evidence for age and racial differences in survival outcomes.…”

Section: Discussionsupporting

confidence: 92%

Prognostic value of site-specific metastases in pancreatic adenocarcinoma: A Surveillance Epidemiology and End Results database analysis

Oweira

Petrausch

Helbling

et al. 2017

WJG

152

109

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AIMTo evaluate the prognostic value of site-specific metastases among patients with metastatic pancreatic carcinoma registered within the Surveillance, Epidemiology and End Results (SEER) database.METHODSSEER database (2010-2013) has been queried through SEER*Stat program to determine the presentation, treatment outcomes and prognostic outcomes of metastatic pancreatic adenocarcinoma according to the site of metastasis. In this study, metastatic pancreatic adenocarcinoma patients were classified according to the site of metastases (liver, lung, bone, brain and distant lymph nodes). We utilized chi-square test to compare the clinicopathological characteristics among different sites of metastases. We used Kaplan-Meier analysis and log-rank testing for survival comparisons. We employed Cox proportional model to perform multivariate analyses of the patient population; and accordingly hazard ratios with corresponding 95%CI were generated. Statistical significance was considered if a two-tailed P value < 0.05 was achieved.RESULTSA total of 13233 patients with stage IV pancreatic cancer and known sites of distant metastases were identified in the period from 2010-2013 and they were included into the current analysis. Patients with isolated distant nodal involvement or lung metastases have better overall and pancreatic cancer-specific survival compared to patients with isolated liver metastases (for overall survival: lung vs liver metastases: P < 0.0001; distant nodal vs liver metastases: P < 0.0001) (for pancreatic cancer-specific survival: lung vs liver metastases: P < 0.0001; distant nodal vs liver metastases: P < 0.0001). Multivariate analysis revealed that age < 65 years, white race, being married, female gender; surgery to the primary tumor and surgery to the metastatic disease were associated with better overall survival and pancreatic cancer-specific survival.CONCLUSIONPancreatic adenocarcinoma patients with isolated liver metastases have worse outcomes compared to patients with isolated lung or distant nodal metastases. Further research is needed to identify the highly selected subset of patients who may benefit from local treatment of the primary tumor and/or metastatic disease.

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Section: Discussionsupporting

confidence: 92%

Prognostic value of site-specific metastases in pancreatic adenocarcinoma: A Surveillance Epidemiology and End Results database analysis

Oweira

Petrausch

Helbling

et al. 2017

WJG

152

109

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“…Another surprising factor was that unmarried patients had a 32% reduced risk of receiving CRN. This has not been reported previously in this setting, but may reflect the observation in many cancers that married patients receive more treatment and better outcomes .…”

Section: Discussionsupporting

confidence: 45%

Cytoreductive nephrectomy for metastatic renal cell carcinoma: inequities in access exist despite improved survival

Patel

Beattie

Bang³

et al. 2017

Cancer Medicine

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The use of cytoreductive nephrectomy (CRN) in the targeted therapy era is still debated. We aimed to determine factors associated with reduced use of CRN and determine the effect of CRN on overall survival in patients with metastatic renal cell carcinoma (RCC). All advanced RCC diagnosed between 2001 and 2009 in New South Wales, Australia, were identified from the Central Cancer Registry. Records of treatment and death were electronically linked. Follow‐up was to the end of 2011. Multivariable logistic regression analysis was used to determine factors associated with the receipt of CRN. Cox proportional hazards model was used to determine factors associated with survival. A total of 1062 patients were identified with metastatic RCC of whom 289 (27%) received CRN. There was no difference in the use of CRN over the time period of the study. Females (OR 0.68 (95% CI: 0.48–0.96)), unmarried individuals (OR 0.68 (95% CI: 0.48–0.96)), treatment in a nonteaching hospital (OR 0.26 (95% CI: 0.18–0.36)) and individuals without private insurance (OR 0.29 (95% CI: 0.20–0.41)) all had reduced likelihood of receiving CRN. On multivariable analysis, not receiving CRN resulted in a 90% increase in death (HR 1.90 (95% CI: 1.61–2.25)). In addition, increasing age (P < 0.001), increasing Charlson comorbidity status (P = 0.002) and female gender also had a significant independent association with death. Despite a strong association with improved survival, individuals who are elderly, female, have treatment in a nonteaching facility or have no private insurance have a reduced likelihood of receiving CRN.

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“…Besides, several recent studies have shown that ignoring the effects of dying from other causes, unmarried gastric cancer, especially widowed patients, have a higher risk of all-cause mortality and GCSM [52,53]. Furthermore, in another study, the authors reported that marriage had a protective effect on the undertreatment and other causes of mortality [54]. However, the results of the competing risk model show that there was no difference in GCSM of the married and unmarried patients, and the risk of the later dying from other causes is signi cantly higher than the former.…”

Section: Discussionmentioning

confidence: 95%

“…Therefore, the contradiction between GCSM and all-cause mortality mainly aroused from the higher risk of competing events in unmarried gastric cancer. Furthermore, married patients who bene ted from their spouse's support and care may reduce side effect on the survival from other diseases and improve the survival rate of gastric cancer [54].…”

Section: Discussionmentioning

confidence: 99%

Cancer-Specific Survival Analysis in Patients with Gastric Cancer: Based on Competing Risk Model

Zhu

et al. 2020

Preprint

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BackgroundCompeting risk events are prone to cause bias in the estimation of all-cause mortality. In order to eliminate the impact of competing events on survival analysis, we constructed a competing risk model. Besides, we attempted to build nomograms to predict gastric cancer-specific mortality (GCSM) and other-cause mortality (OCM).MethodsThe competing risk model was constructed to evaluate all-cause mortality, GCSM and OCM, by using the gastric cancer data from 2004 to 2013 in the Surveillance, Epidemiology, and End Results Program (SEER) dataset. Nomograms were used to predict the risk of individual dying from gastric cancer and other causes based on competing risk model.ResultsA total of 15299 cases were screened out. The 1-year, 5-year, and 8-year survival probabilities were 48.9 %, 22.1 %, and 16.4 % for all-cause mortality, respectively. Univariate and multivariate analyses showed that sex, race, marital status, age at diagnosis, malignant, tumor diameter and TNM staging were all significant prognostic factors of gastric cancer. The GCSM and OCM models showed the risk of death treated by radiotherapy decreased from 0.689 to 0.494 after considering competing risk events. Furthermore, the nomograms showed good accuracy for GCSM prediction of the 1-,5-,8-year, the AUC values of the nomograms were 0.801 [95% CI, 0.793–0.808], 0.820 [95% CI, 0.810–0.829] and 0.823 [95% CI, 0.808–0.844]. The AUC values of the nomograms for predicting 1-, 5-, and 8-year OCM were 0.784 [95% CI, 0.778–0.792], 0.755 [95% CI, 0.748–0.765] and 0.747 [95% CI, 0.739–0.759].ConclusionsOverall, the prognosis of patients with Gastric cancer is poor. The competing risk model could accurately evaluate the probability of dying from gastric cancer and other causes. Nomograms showed relatively good performance and could be considered as convenient individualized predictive tools for predicting GCSM and OCM.

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Marital status and survival in patients with gastric cancer

Cited by 56 publications

References 43 publications

Prognostic value of site-specific metastases in pancreatic adenocarcinoma: A Surveillance Epidemiology and End Results database analysis

Prognostic value of site-specific metastases in pancreatic adenocarcinoma: A Surveillance Epidemiology and End Results database analysis

Cytoreductive nephrectomy for metastatic renal cell carcinoma: inequities in access exist despite improved survival

Cancer-Specific Survival Analysis in Patients with Gastric Cancer: Based on Competing Risk Model

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