Effect of marital status on the survival of patients with gallbladder cancer treated with surgical resection: a population-based study

Abstract

Marital status has been reported as an independent prognostic factor for survival in various cancers, but it has been rarely studied in gallbladder cancer treated by surgical resection. We retrospectively studied Surveillance, Epidemiology, and End Results (SEER) population-based data and identified 9,041 cases of gallbladder cancer with surgical treatment between 1988 and 2013. The patients were categorized according to marital status, as "married," "never married," "widowed," or "divorced/separated." Patients in the widowed group had a higher proportion of women within-group comparisons, a higher rate of white race, a greater proportion of older (≥ 60 years) patients, more frequency of adenocarcinoma, a greater number of tumors at well/moderate pathological grading, and more prevalence at the localized SEER stage, all of which were statistically significant (P < 0.001). Marital status was confirmed to be an independent prognostic factor by multivariate analysis (P < 0.001). Married patients had higher 5-year gallbladder cancer cause-specific survival than unmarried patients (P < 0.001); conversely, widowed patients had the lowest gallbladder cancer cause-specific survival compared with all other patients. Conclusions marital status is an important prognostic risk factor for survival in patients with gallbladder cancer treated with surgical resection. Widowed patients have the highest risk of death compared with other groups.

Keywords: SEER; gallbladder cancer; marital status; surgery; survival analysis.

Figure 1. Survival curves in gallbladder cancer patients treated with surgical resection between the unmarried patients and the married patients

χ² = 74.829, P < 0.001.

Figure 2. Survival curves in gallbladder cancer patients treated with surgical resection according to marital status

(A) Overall: χ² = 113.429, P < 0.001; (B) Well/moderate: χ² = 69.264, P < 0.001; (C) Poor/anaplastic: χ² = 37.754, P < 0.001; (D) Localized: χ² = 124.013, P < 0.001; (E) Regional: χ2 = 29.216, P < 0.001; (F) Distant: χ² = 68.705, P < 0.001.