Marital status, an independent predictor for survival of gastric neuroendocrine neoplasm patients: a SEER database analysis

• Published in: BMC endocrine disorders 2020-07, Vol.20 (1), p.1-111, Article 111
• Main Authors: Zhou, Yu-Jie, Lu, Xiao-Fan, Zheng, Kenneth I, Wang, Qi-Wen, Chen, Jin-Nan, Zhang, Qing-Wei, Yan, Fang-Rong, Li, Xiao-Bo
• Format: Article
• Language: English
• Subjects: Age; Cancer; Comparative analysis; Divorce; Epidemiology; Ethnicity; Gastric neuroendocrine neoplasms; Marital status; Marriage; Medical prognosis; Metastasis; Mortality; Neuroendocrine tumors; Patient outcomes; Patients; Prognosis; Propensity score matching; Risk factors; Social support; Studies; Surgery; Survival; Tumors; Variables
• ISSN: 1472-6823; 1472-6823
• DOI: 10.1186/s12902-020-00565-w

Background Marital status proves to be an independent prognostic factor in a variety of cancers. However, its prognostic impact on gastric neuroendocrine neoplasms (G-NEN) has not been investigated. Methods We identified 3947 G-NEN patients from the Surveillance, Epidemiology, and End Results (SEER) database. Meanwhile, propensity scores for marital status were used to match 506 unmarried patients with 506 married patients. We used Kaplan-Meier method and multivariate Cox regression to analyse the association between marital status and the overall survival (OS) and G-NEN cause-specific survival (CSS) before matching and after matching. Results Married patients enjoyed better OS and CSS, compared with divorced/separated, single, and widowed patients. Multivariate Cox regression analysis indicated that unmarried status was associated with higher mortality hazards for both OS and CSS among G-NEN patients. Additionally, widowed individuals had the highest risks of overall (adjusted hazard ratio (HR): 1.56, 95% confidence interval (CI): 1.35-1.81, P < 0.001) and cancer-specific mortality (adjusted HR: 1.33, 95% CI: 1.05-1.68, P = 0.02) compared to other unmarried groups in both males and females. Furthermore, unmarried status remained an independent prognostic and risk factor for both OS (HR 1.51, 95% CI 1.19-1.90, P = 0.001) and CSS (HR 1.50, 95% CI 1.10-2.05, P = 0.01) in 1:1 propensity score-matched analysis. Conclusion Marital status was an independent prognostic factor for G-NEN. Meanwhile, widowed patients with G-NEN had the highest risk of death compared with single, married, and divorced/separated patients. Keywords: Gastric neuroendocrine neoplasms, Marriage, Propensity score matching