Marital status independently predicts survival of patients with upper urinary tract urothelial carcinoma: A population-based study

Background: To evaluate impact of marital status on survival of patients with upper urinary tract urothelial carcinoma (UTUC).

Methods: Data of patients diagnosed with UTUC from 2010 to 2015 were identified and retrieved from the Surveillance, Epidemiology, and End Results database. The impact of marital status on overall survival (OS) and cancer-specific survival (CSS) was analyzed using Kaplan-Meier survival curve method and compared with the log-rank test. Multivariate survival analysis of OS and CSS was conducted using the Cox proportional hazards regression model.

Results: A total of 4520 eligible patients with UTUC were included in this study. The 5-year OS rates of married patients, never-married patients, and separated, divorced, or widowed (SDW) patients were 47.3%, 43.7%, and 39.2%, respectively (P < 0.001), and the corresponding 5-year CSS rates were 57.7%, 55.2%, and 51.5%, respectively (P = 0.005). In multivariate analyses, marital status was an independent prognostic factor for OS (P < 0.001) and CSS (P = 0.002) of patients with UTUC. Compared to married patients, never married (hazard ratio [HR], 1.187; 95% confidence interval [CI], 1.016-1.386 for OS; HR, 1.102; 95% CI, 0.877-1.385 for CSS) and SDW (HR, 1.205; 95% CI, 1.094-1.327 for OS; HR, 1.309; 95% CI, 1.131-1.514 for CSS) patients showed poor OS and unfavorable CSS.

Conclusions: Marital status was an independent prognostic factor for OS and CSS in patients with UTUC. Married patients with UTUC experienced longer OS and a more favorable CSS than their never married and SDW counterparts.