Association Between Marital Status and Long-Term Survival in Small Intestinal Stromal Tumors: A SEER-Based Study

IntroductionEvidence indicates that being married may influence prognosis in various malignancies; however, whether this association extends to small intestinal stromal tumors (SISTs) remains unclear. To address this gap, we analyzed population-based data to determine the prognostic significance of marital status for SIST patients.MethodsThis population-based, retrospective cohort study leveraged data from the Surveillance, Epidemiology, and End Results (SEER) database for the period 2000 to 2019. We classified patients as either married or unmarried according to their recorded marital status. To minimize bias from confounders, we performed 1:1 propensity score matching (PSM). Survival outcomes, including overall survival (OS) and cancer-specific survival (CSS), were estimated via the Kaplan-Meier method and Cox proportional hazards models.ResultsOur analysis included 3315 SIST patients, of whom 2132 were married and 1183 were unmarried. Compared with unmarried individuals, married patients experienced significantly better OS and CSS (both P<0.05). Multivariable analysis identified marital status as an independent predictor for both endpoints, with adjusted HRs of 1.35 (95% CI: 1.20-1.52) for OS and 1.27 (95% CI: 1.10-1.48) for CSS. Following PSM, the survival advantage for married patients persisted (P<0.05 for both OS and CSS). Notably, the 5-year OS and CSS rates favored the married cohort over the unmarried cohort (75.2% vs. 64.0%, P <0.001; 83.7% vs. 76.1%, P = 0.001, respectively). Subgroup analyses further revealed that the survival benefit associated with marriage was particularly evident among elderly, female, Caucasian, and surgically treated patients.ConclusionsMarital status independently predicts prognosis in small intestinal stromal tumors (SISTs), with married patients exhibiting superior outcomes.