濾胞性リンパ腫患者における婚姻状況が生存に及ぼす影響

Although marital status has been associated with survival in several cancers, evidence regarding its prognostic relevance in follicular lymphoma (FL), an indolent lymphoma characterized by prolonged survival, remains limited. In this population-based study using the SEER database, we identified 23,434 adult patients diagnosed with FL between 2013 and 2022. Propensity score matching was performed to balance baseline characteristics, and survival outcomes were assessed using Kaplan-Meier analysis and Cox proportional hazards models. In the overall cohort, unmarried patients were more likely to be female, older, and present with B symptoms (all P < 0.001), and demonstrated significantly lower 5-year overall survival (OS: 72.8% vs. 81.0%, P < 0.001) and cause-specific survival (CSS: 84.9% vs. 90.6%, P < 0.001) compared with married patients. After 1:1 propensity score matching on age, sex, race/ethnicity, Ann Arbor stage, B symptoms, treatment status, prior cancer history, and diagnosis year (matched cohort, n = 16,384), this survival disparity persisted (5-year OS: 72.5% vs. 81.3%; CSS: 84.7% vs. 90.7%; both P < 0.001). Multivariable Cox regression confirmed that unmarried status was independently associated with increased risks of OS (HR, 1.62; 95% CI, 1.53-1.71, P < 0.001) and CSS (HR, 1.77; 95% CI, 1.63-1.92, P < 0.001). These findings suggest that unmarried status is an independent adverse prognostic factor in patients with FL and highlight additional attention may be warranted for unmarried individuals during long-term disease management.