Saira Khan1, Kenneth G Nepple2, Adam S Kibel3, Gurdarshan Sandhu4, Dorina Kallogjeri5, Seth Strope6, Robert Grubb7, Kathleen Y Wolin8, Siobhan Sutcliffe9. 1. Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 S. Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA. khans@wustl.edu. 2. Department of Urology, Carver College of Medicine, University of Iowa Health Care, 3228 RCP, Iowa City, IA, 52242, USA. 3. Division of Urology, Department of Surgery, Brigham and Women's Hospital, Harvard School of Medicine, 45 Francis St., ASB11-3, Boston, MA, 02115, USA. 4. Mercy Clinic Urology, David C. Pratt Cancer Center, 607 S. New Ballas Rd., Suite 3100, St. Louis, MO, 63141, USA. 5. Department of Otolaryngology, Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., Campus Box 8042, St. Louis, MO, 63110, USA. 6. Urology of St. Louis, 12855 North Forty Dr., Suite 375, St. Louis, MO, 63141, USA. 7. Department of Urology, Medical University of South Carolina, 135 Rutledge Ave., Charleston, SC, 29425, USA. 8. Interactive Health Inc., 300 N. Elizabeth St., Chicago, IL, 60607, USA. 9. Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 S. Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA.
Abstract
PURPOSE: The purpose of this study was to determine the association of marital status, a marker of social support, with all-cause and prostate cancer-specific mortality in a cohort of men with early-stage prostate cancer treated with radical prostatectomy. METHODS: We conducted a retrospective cohort study of 3,579 men treated for localized (stage 1-2) prostate cancer with radical prostatectomy at a single institution between 1994 and 2004. Marital status (not married vs. married) and marital history (never married, divorced, widowed vs. married) at the time of prostatectomy were examined in relation to (1) all-cause mortality and (2) prostate cancer-specific mortality using Cox proportional hazards regression. RESULTS: Not being married (vs. married) at the time of radical prostatectomy was associated with an increased risk of all-cause mortality [Hazard Ratio (HR) 1.42; 95% Confidence Interval (CI) 1.10, 1.85]. Similarly, in analyses of marital history, never-married men were at highest risk of all-cause mortality (HR 1.77, 95% CI 1.19, 2.63). Unmarried status (vs. married) was also associated with an increased risk of prostate cancer-specific mortality (HR 1.97; 95% CI 1.01, 3.83). CONCLUSIONS: Unmarried men with prostate cancer were at greater risk for death after radical prostatectomy. Among married men with prostate cancer, marriage likely serves as a multi-faceted proxy for many protective factors including social support. Future studies should explore the mechanisms underlying these findings to inform the development of novel prostate cancer survival interventions for unmarried men and those with low social support.
PURPOSE: The purpose of this study was to determine the association of marital status, a marker of social support, with all-cause and prostate cancer-specific mortality in a cohort of men with early-stage prostate cancer treated with radical prostatectomy. METHODS: We conducted a retrospective cohort study of 3,579 men treated for localized (stage 1-2) prostate cancer with radical prostatectomy at a single institution between 1994 and 2004. Marital status (not married vs. married) and marital history (never married, divorced, widowed vs. married) at the time of prostatectomy were examined in relation to (1) all-cause mortality and (2) prostate cancer-specific mortality using Cox proportional hazards regression. RESULTS: Not being married (vs. married) at the time of radical prostatectomy was associated with an increased risk of all-cause mortality [Hazard Ratio (HR) 1.42; 95% Confidence Interval (CI) 1.10, 1.85]. Similarly, in analyses of marital history, never-married men were at highest risk of all-cause mortality (HR 1.77, 95% CI 1.19, 2.63). Unmarried status (vs. married) was also associated with an increased risk of prostate cancer-specific mortality (HR 1.97; 95% CI 1.01, 3.83). CONCLUSIONS: Unmarried men with prostate cancer were at greater risk for death after radical prostatectomy. Among married men with prostate cancer, marriage likely serves as a multi-faceted proxy for many protective factors including social support. Future studies should explore the mechanisms underlying these findings to inform the development of novel prostate cancer survival interventions for unmarried men and those with low social support.
Entities:
Keywords:
Marital status; Married; Mortality; Prostate cancer; Radical prostatectomy; Single
Authors: Firas Abdollah; Maxine Sun; Rodolphe Thuret; Al'a Abdo; Monica Morgan; Claudio Jeldres; Shahrokh F Shariat; Paul Perrotte; Francesco Montorsi; Pierre I Karakiewicz Journal: Cancer Causes Control Date: 2011-06-05 Impact factor: 2.506
Authors: Laura P Forsythe; Catherine M Alfano; Erin E Kent; Kathryn E Weaver; Keith Bellizzi; Neeraj Arora; Noreen Aziz; Gretchen Keel; Julia H Rowland Journal: Psychooncology Date: 2014-01-30 Impact factor: 3.894
Authors: Ayal A Aizer; Ming-Hui Chen; Ellen P McCarthy; Mallika L Mendu; Sophia Koo; Tyler J Wilhite; Powell L Graham; Toni K Choueiri; Karen E Hoffman; Neil E Martin; Jim C Hu; Paul L Nguyen Journal: J Clin Oncol Date: 2013-09-23 Impact factor: 44.544
Authors: Rosalind A Eeles; Ali Amin Al Olama; Sara Benlloch; Edward J Saunders; Daniel A Leongamornlert; Malgorzata Tymrakiewicz; Maya Ghoussaini; Craig Luccarini; Joe Dennis; Sarah Jugurnauth-Little; Tokhir Dadaev; David E Neal; Freddie C Hamdy; Jenny L Donovan; Ken Muir; Graham G Giles; Gianluca Severi; Fredrik Wiklund; Henrik Gronberg; Christopher A Haiman; Fredrick Schumacher; Brian E Henderson; Loic Le Marchand; Sara Lindstrom; Peter Kraft; David J Hunter; Susan Gapstur; Stephen J Chanock; Sonja I Berndt; Demetrius Albanes; Gerald Andriole; Johanna Schleutker; Maren Weischer; Federico Canzian; Elio Riboli; Tim J Key; Ruth C Travis; Daniele Campa; Sue A Ingles; Esther M John; Richard B Hayes; Paul D P Pharoah; Nora Pashayan; Kay-Tee Khaw; Janet L Stanford; Elaine A Ostrander; Lisa B Signorello; Stephen N Thibodeau; Dan Schaid; Christiane Maier; Walther Vogel; Adam S Kibel; Cezary Cybulski; Jan Lubinski; Lisa Cannon-Albright; Hermann Brenner; Jong Y Park; Radka Kaneva; Jyotsna Batra; Amanda B Spurdle; Judith A Clements; Manuel R Teixeira; Ed Dicks; Andrew Lee; Alison M Dunning; Caroline Baynes; Don Conroy; Melanie J Maranian; Shahana Ahmed; Koveela Govindasami; Michelle Guy; Rosemary A Wilkinson; Emma J Sawyer; Angela Morgan; David P Dearnaley; Alan Horwich; Robert A Huddart; Vincent S Khoo; Christopher C Parker; Nicholas J Van As; Christopher J Woodhouse; Alan Thompson; Tim Dudderidge; Chris Ogden; Colin S Cooper; Artitaya Lophatananon; Angela Cox; Melissa C Southey; John L Hopper; Dallas R English; Markus Aly; Jan Adolfsson; Jiangfeng Xu; Siqun L Zheng; Meredith Yeager; Rudolf Kaaks; W Ryan Diver; Mia M Gaudet; Mariana C Stern; Roman Corral; Amit D Joshi; Ahva Shahabi; Tiina Wahlfors; Teuvo L J Tammela; Anssi Auvinen; Jarmo Virtamo; Peter Klarskov; Børge G Nordestgaard; M Andreas Røder; Sune F Nielsen; Stig E Bojesen; Afshan Siddiq; Liesel M Fitzgerald; Suzanne Kolb; Erika M Kwon; Danielle M Karyadi; William J Blot; Wei Zheng; Qiuyin Cai; Shannon K McDonnell; Antje E Rinckleb; Bettina Drake; Graham Colditz; Dominika Wokolorczyk; Robert A Stephenson; Craig Teerlink; Heiko Muller; Dietrich Rothenbacher; Thomas A Sellers; Hui-Yi Lin; Chavdar Slavov; Vanio Mitev; Felicity Lose; Srilakshmi Srinivasan; Sofia Maia; Paula Paulo; Ethan Lange; Kathleen A Cooney; Antonis C Antoniou; Daniel Vincent; François Bacot; Daniel C Tessier; Zsofia Kote-Jarai; Douglas F Easton Journal: Nat Genet Date: 2013-04 Impact factor: 38.330
Authors: Richard G Watt; Anja Heilmann; Wael Sabbah; Tim Newton; Tarani Chandola; Jun Aida; Aubrey Sheiham; Michael Marmot; Ichiro Kawachi; Georgios Tsakos Journal: BMC Public Health Date: 2014-05-30 Impact factor: 3.295
Authors: Xianghong Zhou; Shi Qiu; Kun Jin; Qiming Yuan; Di Jin; Zilong Zhang; Xiaonan Zheng; Jiakun Li; Qiang Wei; Lu Yang Journal: Front Surg Date: 2021-11-26