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Marriage and mortality in bladder carcinoma
Article first published online: 2 AUG 2005
Copyright © 2005 American Cancer Society
Volume 104, Issue 6, pages 1188–1194, 15 September 2005
How to Cite
Gore, J. L., Kwan, L., Saigal, C. S. and Litwin, M. S. (2005), Marriage and mortality in bladder carcinoma. Cancer, 104: 1188–1194. doi: 10.1002/cncr.21295
- Issue published online: 31 AUG 2005
- Article first published online: 2 AUG 2005
- Manuscript Accepted: 25 APR 2005
- Manuscript Revised: 14 APR 2005
- Manuscript Received: 28 FEB 2005
- marital relationship;
- bladder carcinoma;
- radical cystectomy
Being married confers significant benefits in survival for patients with a variety of chronic conditions including breast and prostate carcinoma. The authors attempted to determine whether marital status is associated with survival in patients undergoing radical cystectomy for bladder carcinoma.
The authors identified 7262 subjects from the Surveillance, Epidemiology, and End Results public-use database who underwent radical cystectomy for transitional cell carcinoma of the bladder. They performed survival analyses using Kaplan–Meier estimates and Cox proportional hazards models. The authors created multivariate models to evaluate the independent association between marital status and survival, controlling for pathologic stage, lymph node status, age, race/ethnicity, and gender.
Married subjects were older and more often male, white, and had earlier disease stage at diagnosis. Married subjects had significantly better survival than did single or widowed subjects (P < 0.001), and married subjects revealed a trend toward better survival than separated/divorced subjects (P = 0.20). Multivariate modeling revealed that compared with single subjects, those who were married had better survival, independent of age at the time of diagnosis, gender, race/ethnicity, disease stage, and lymph node status (P < 0.001).
Marriage was associated with improved survival in patients with bladder carcinoma, independent of other factors known to influence mortality in this population. Although the mechanisms underlying this survival advantage are unknown, possibilities include differences in cancer screening, risk behaviors, and access to medical care. The interaction between psychosocial factors and the body's immune function may further explain the differential survival in this cohort. Cancer 2005. © 2005 American Cancer Society.