Impact of marital status and race on outcomes of p

Authors: Kevin Lee Du Kyounghwa Bae Benjamin Movsas Yan Yan Charlene Bryan Deborah Watkins Bruner

Publish Date: 2011/07/01

Volume: 20, Issue: 6, Pages: 1317-1325

PDF Link

Abstract

Previous studies by our group and others have demonstrated the importance of sociodemographic factors in cancerrelated outcomes The identification of these factors has led to novel approaches to the care of the highrisk cancer patient specifically in the adoption of clinical interventions that convey similar benefits as favorable sociodemographic characteristics This study examined the importance of marital status and race as prognostic indicators in men with prostate cancerThis report is a metaanalysis of 3570 patients with prostate cancer treated in three prospective RTOG clinical trials The Kaplan–Meier method was used to estimate the survival rate and the cumulative incidence method was used to analyze biochemical failure rate Hazard ratios were calculated for all covariates using either the Cox or Fine and Gray’s proportional hazards model or logistic regression model with associated 95 confidence intervals and p valuesHazard ratio HR for overall survival OS for single status compared to married status was 136 95 CI 12 to 153 OS HR for nonWhite compared to White patients was 105 CI 092 to 121 In contrast the diseasefree survival DFS HR and biochemical failure BF HR were both not significantly different neither between single and married patients nor between White patients and nonWhite patients Median time to death for married men was 568 years and for single men was 473 years Median time for DFS for married men was 725 years and for single men was 656 years Median time for BF for married men was 781 years and for single men was 705 yearsProstate cancer is the most common visceral cancer in men in the USA The stratification of prostate cancer risk is currently modeled solely on pathologic prognostic factors including PSA and Gleason Score Independent of these pathologic prognostic factors our paper describes the central sociodemographic factor of being single as a negative prognostic indicator Single men are at high risk of poorer outcomes after prostate cancer treatment Intriguingly in our group of patients race was not a significant prognostic factor The findings in this paper add to the body of work that describes important sociodemographic prognostic factors that are currently underappreciated in patients with cancer Future steps will include the validation of these findings in prospective studies and the incorporation of clinical strategies that identify and compensate for sociodemographic factors that predict for poorer cancer outcomesSupported by RTOG U10 CA21661 and CCOP U10 CA37422 grants from the NCI as well as Pennsylvania Commonwealth Universal Research Enhancement CURE Program ME02149 This papers contents are the sole responsibility of the authors and do not necessarily represent the official views of the NCI

Keywords: