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. 2019 Nov 1:25:8190-8203.
doi: 10.12659/MSM.918048.

Marital Status and Survival in Osteosarcoma Patients: An Analysis of the Surveillance, Epidemiology, and End Results (SEER) Database

Shui Qiu  1 , Lin Tao  2 , Yue Zhu  2
Affiliations

Marital Status and Survival in Osteosarcoma Patients: An Analysis of the Surveillance, Epidemiology, and End Results (SEER) Database

Shui Qiu et al. Med Sci Monit. .

Abstract

BACKGROUND As the most malignant bone tumor globally, osteosarcoma has drawn increased attention. However, no studies have focused on the association between marital status and survival rate. The objectives of this study were to determine the association between marital and survival rate of osteosarcoma patients based on the SEER database. MATERIAL AND METHODS We enrolled a total of 2725 osteosarcoma patients between 1973 and 2015, including 1184 married, 154 divorced/separated, 136 widowed, and 1251 never-married patients. Survival rate was determined based on the Kaplan-Meier method in different marital subgroups. Multivariate Cox regression analysis was performed to explore independent prognostic factors. RESULTS The 5-year overall survival (OS) and cancer-specific survival (CSS) rates of the married, separated/divorced, widowed, and never-married subjects were 45.93%, 41.39%, 19.08%, and 57.21% (OS), and 49.97%, 45.85%, 22.14%, and 60.69% (CSS), respectively. The survival outcome among subgroups exhibited a clear difference, with a log-rank test p-value <0.0001. Multivariate Cox regression showed that widowhood served as the independent prognostic factor for decreased OS rather than marriage (HR, 1.246; 95% CI, 1.011-1.536; p-value=0.039) and CSS (HR, 1.34; 95% CI, 1.07-1.68; p-value=0.01). Moreover, the OS and CSS in widowed patients were lower. Additionally, based on the propensity score matching (PSM) method, the prognosis of married patients was better than that of unmarried subjects. CONCLUSIONS Marital status was correlated with the survival rate, meaning that married patients had higher survival than widowed subjects, who had worse prognoses of osteosarcoma.

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Conflict of interest statement

Conflicts of interest

None.

Figures

Figure 1
Figure 1
The data selection steps of the present study.
Figure 2
Figure 2
Kaplan-Meier survival plots exhibited by osteosarcoma patients based on marital status. (A) OS. (B) CSS.
Figure 3
Figure 3
Multivariate Cox analysis of OS in osteosarcoma patients by forest plots. The X-axis shows the hazard ratio and 95% CI of each subgroup, ticks follow the arrangement of 0, 0.25, 0.5, 0.75, 1.0, 1.25, 1.5, 1.75, and 2.0.
Figure 4
Figure 4
Multivariate Cox analysis of CSS in osteosarcoma patients by forest plots. The X-axis shows the hazard ratio and 95% CI of each subgroup, ticks follow the arrangement of 0, 0.25, 0.5, 0.75, 1.0, 1.25, 1.5, 1.75, and 2.0.
Figure 5
Figure 5
Subgroup analyses on osteosarcoma patients stratified by tumor grade. (A) OS. (B) CSS.
Figure 6
Figure 6
Other subgroup analysis on how marital status affects OS among osteosarcoma patients. (A) Age at diagnosis. (B) Sex. (C) TNM stage. (D) Surgery status.
Figure 7
Figure 7
Other subgroup analysis of the effects of marital statuses on CSS among osteosarcoma patients. (A) Age at diagnosis. (B) Sex. (C) TNM stage. (D) Surgery status.
Figure 8
Figure 8
Kaplan-Meier survival curves exhibited by the osteosarcoma patients based on marital status after PSM. (A) OS. (B) CSS.
See this image and copyright information in PMC

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