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Morra, S; Scheipner, L; Baudo, A; Jannello, LMI; de, Angelis, M; Siech, C; Goyal, JA; Touma, N; Tian, Z; Saad, F; Creta, M; Califano, G; Celentano, G; Shariat, SF; Ahyai, S; Carmignani, L; de, Cobelli, O; Musi, G; Briganti, A; Chun, FKH; Longo, N; Karakiewicz, PI.
Contemporary sex-specific analysis of the association of marital status with cancer-specific mortality in primary urethral carcinoma patients.
Urol Oncol. 2024; 42(2):31.e1-31.e8 Doi: 10.1016/j.urolonc.2023.10.013
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Co-authors Med Uni Graz: Ahyai Sascha; Scheipner Lukas
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Abstract:: BACKGROUND: It is unknown whether married status may be associated with lower cancer-specific mortality (CSM) rates in primary urethral carcinoma (PUC) patients. To test for differences in CSM rates, according to marital status, we relied on the Surveillance, Epidemiology, and End Results (SEER) database 2000-2020. METHODS: Patient (age, sex, race/ethnicity, marital status), tumor (stage, histology), and treatment (surgery, systemic therapy) characteristics of PUC patients were tabulated. Then, Kaplan-Meier plots, as well as univariable and multivariable Cox regression (MCR) models tested for differences in CSM rates according to marital status in overall cohort and then in sex-specific subgroup analyses. RESULTS: Of all 1,571 PUC patients, 70% were male vs. 30% female. Females were statistically significantly younger (68 vs. 73 years), more frequently unmarried (54 vs. 28%), non-Caucasian (43 vs. 24%), more frequently harbored T_3-4N₀M₀ (39 vs. 18%) and less frequently T_1-2N₀M₀ (53 vs. 69%) or T_anyN_1-2M₀/T_anyN_anyM₁ (8 vs. 13%), relative to males. Moreover, we recorded differences in histotype proportions in females vs. males (urothelial 30 vs. 64%; squamous 24 vs. 22%; adenocarcinoma 36 vs. 7%; others 10 vs. 6%) and surgical treatment (none 22 vs. 17%; excisional biopsy 22 vs. 36%; partial urethrectomy 14 vs. 16%; radical urethrectomy 42 vs. 31%). In MCR models focusing on the entire cohort, married status independently predicted lower CSM (hazard ratio [HR]:0.82; P = 0.02). Similarly, in MCR models focusing on females, married status independently predicted lower CSM (HR:0.73; P = 0.03). Conversely, in MCR models focusing on males, married status failed to independently predict lower CSM (HR:0.89; P = 0.3). CONCLUSIONS: Married status was associated with lower CSM in PUC patients. However, this benefit applies to female PUC patients, but not to their male counterparts.
Find related publications in this database (using NLM MeSH Indexing): Humans - administration & dosage; Male - administration & dosage; Female - administration & dosage; Marital Status - administration & dosage; Proportional Hazards Models - administration & dosage; Adenocarcinoma - administration & dosage; SEER Program - administration & dosage
Find related publications in this database (Keywords): marital status; primary urethral carcinoma; SEER program; sex-specific analysis; survival differences