Marriage and mortality in bladder carcinoma

Area of Science:

• Oncology
• Urology
• Public Health

Background:

• Marriage is associated with improved survival in various chronic conditions.
• Previous research indicates survival benefits for married patients with breast and prostate cancer.
• The impact of marital status on bladder carcinoma survival post-radical cystectomy requires investigation.

Purpose of the Study:

• To determine if marital status is associated with survival outcomes in patients treated with radical cystectomy for bladder carcinoma.
• To analyze the independent effect of marital status on mortality in this patient cohort.

Main Methods:

• Utilized data from 7262 subjects in the Surveillance, Epidemiology, and End Results (SEER) database.
• Conducted survival analyses using Kaplan-Meier estimates and Cox proportional hazards models.
• Developed multivariate models to assess the independent association between marital status and survival, controlling for key demographic and clinical factors.

Main Results:

• Married patients were older, more frequently male, white, and diagnosed with earlier disease stages.
• Married subjects demonstrated significantly better survival compared to single or widowed subjects (P < 0.001).
• Multivariate analysis confirmed that marriage independently predicted better survival, irrespective of age, gender, race/ethnicity, disease stage, and lymph node status (P < 0.001).

Conclusions:

• Marriage is independently associated with improved survival in bladder carcinoma patients undergoing radical cystectomy.
• Potential mechanisms for this survival advantage include differences in cancer screening, health behaviors, and healthcare access.
• The interplay of psychosocial factors and immune function may contribute to differential survival outcomes.