婚姻状态对肾癌患者预后的影响:基于SEER数据库分析

Influence of marital status on overall survival in patients with Renal Carcinoma

目的探讨婚姻状态与肾癌患者临床特征及预后的关系。方法利用美国SEER数据库中2010年1月至2015年12月间诊断为肾癌的病例回顾性分析婚姻状态与总生存期(Overall-survival,OS)的关系;应用单因素和多因素Cox分析婚姻状态(已婚,未婚和离异、分居、丧偶)对肾癌OS的影响。结果共入组43392例患者中,已婚组占65.0%,未婚组占16.4%,分居、离婚、丧偶(SDW)组占18.5%。单因素及多因素Cox回归分析表明,相比于已婚组,未婚组OS显著性缩短(单因素:0.75,95%CI=0.69~0.81,P<0.05;多因素:HR=1.32,95%CI=1.22~1.42,P<0.05),同样SDW组OS较已婚组也显著性降低(单因素:HR=1.05,95%CI=1.03~1.12,P<0.05;多因素:HR=1.39,95%CI=1.23~1.45,P<0.05)。结论分居、离婚、丧偶(SDW)和未婚肾癌患者OS较短;该风险独立于年龄、人种、组织学分级、就诊年份等因素中。提示医护人员在临床实践中需多关心离婚、分居、丧偶和未婚等人群。

Objective To investigate the relationship between marital status and prognosis of patients with renal carcinoma.Methods The American Surveillance,Epidemiology,and End Results(SEER)database was used to analyze patients who were diagnosed with renal carcinoma from January 2010 to December 2015.Univariate and multivariate Cox regression analyses were performed to test the relationship between marital status(married,unmarried and separated/divorced/widowed,SDW)and overall survival(OS).Results Of the total 43,392 patients enrolled,65.0%were married,16.4%were unmarried,and 18.5%were separated,divorced,or widowed(SDW).Univariate and Multivariate Cox regression demonstrated that unmarried patients had significantly shorter OS compared to the married group(Univariate:HR=0.75,95%CI=0.69~0.81,P<0.05;Multivariate:HR=1.32,95%CI=1.22~1.42,P<0.05).Similarly,the OS of SDW group was significantly lower than that of married group(Univariate:HR=1.05,95%CI=1.03~1.12,P<0.05;Multivariate:HR=1.39,95%CI=1.23~1.45,P<0.05).Conclusion SDW and unmarried renal cancer patients had shorter OS.The risk was independent of age,race,histological grade,year of visit,and other factors.It was suggested that medical staff should pay more attention to divorced,separated,widowed and unmarried people in clinical practice.