The impact of marriage on the overall survival of prostate cancer patients: A Surveillance, Epidemiology, and End Results (SEER) analysis

Abstract

Introduction: Marital status has long been associated with positive patient outcomes in several malignances; however, little is known about its influence on prostate cancer. We analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database to evaluate whether married patients with prostate cancer had a better prognosis than unmarried patients.

Methods: We identified 824 554 patients diagnosed with prostate cancer between 1973 and 2012 in the SEER database. Using the Cox proportional hazard models, we analyzed the impact of marital status (single, married, divorced/separated, and widowed) on survival after diagnosis with prostate cancer. Chi-square tests were used to analyze the association between marital status and other variables, and the Kaplan-Meier method was used to estimate survival curves.

Results: Married men were more likely to be diagnosed with a lower Gleason score and undergo surgery than patients in the other groups (p<0.001). The married group had a lower risk of mortality caused by prostate cancer than the other groups. The five-year survival rate for married patients was higher than that for patients in the other groups.

Conclusions: Marital status is a prognostic factor for the survival of prostate cancer patients, as being married was associated with better outcomes.

Fig 1

Flow chart of patients’ cohort definition.

Fig. 2

Kaplan-Meier plots of survival curves by marital status. The five-year survival rate was 81.5% for married, 77.9% for single, 77.3% for divorced/separated, and 58.5% for widowed groups.

Fig. 3

Median age at diagnosis and five-year survival rates by Gleason score and marital status. (A) Five-year survival rate and median age among patients with Gleason scores ≤7; (B) five-year survival rate and median age among patients with Gleason scores >7.