Marital status and gender affect stage, tumor grade, treatment type and cancer specific mortality in T N M renal cell carcinoma

Marchioni, Michele; Martel, Tristan; Bandini, Marco; Pompe, Raisa; Tian, Zhe; Kapoor, Anil; Cindolo, Luca; Autorino, Riccardo; Briganti, Alberto; Shariat, Shahrokh; Schips, Luigi; Karakiewicz, Pierre
December 2017
World Journal of Urology;Dec2017, Vol. 35 Issue 12, p1899
Academic Journal
Purpose: To examine the effect of marital status and gender on stage at diagnosis, tumor grade, treatment type and cancer specific mortality (CSM) in patients with localized renal cell carcinoma (RCC). Methods: Within Surveillance, Epidemiology, and End Results registry (2001-2013), we identified 57,700 patients with T N M RCC. Logistic regression and competing-risks regression models tested the effect of marital status and gender on stage, tumor grade, treatment type and cancer specific mortality (CSM). Results: Of all patients, 8.8, 10.6 and 14.8% were, respectively, widowed, separated/divorced and never married. The three categories accounted for 3.9, 9.0 and 14.9% of males (35,641) and for 16.7, 13.1 and 14.7% of females (22,059). Widowed (OR 1.13, p = 0.04), separated/divorced (OR 1.16, p = 0.02) and never married status (OR 1.38, p < 0.001) predisposed to higher rate of no surgical treatment. Widowed (HR 1.32, p < 0.001) and separated/divorced (HR 1.32, p < 0.001) status predisposed to higher CSM. Male gender predisposed to higher T-stage (OR 1.12, p < 0.001), higher tumor grade (OR 1.35, p < 0.001), no surgical treatment (OR 1.23, p < 0.001) and higher CSM (1.13, p = 0.01). Interaction tests between gender and marital status failed to reach independent predictor status in all analyses. Conclusions: Male patients are at higher risk of less favorable baseline characteristics. Additionally, male, widowed and separated/divorced patients exhibit worse cancer control outcomes after treatment for T N M RCC. These observations indicate the need of more focused attention to those patients prior to, as well as after treatment for localized RCC.


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