@article{68cbcfb2e057406f97ccadbb768deaeb,
title = "Unmarried men have worse oncologic outcomes after radical cystectomy for nonmetastatic urothelial bladder cancer: Urologic Oncology: Seminars and Original Investigations",
abstract = "Background: Unmarried status is an established risk factor for worse cancer control outcomes and survival in various malignancies. We tested the effect of marital status on the rate of nonorgan confined disease as well as on cancer-specific mortality (CSM) in patients who underwent radical cystectomy for nonmetastatic urothelial bladder cancer (UCUB). Methods: Within the Surveillance, Epidemiology and End Results database (2007-2015), we identified 11,167 patients (8,639 men and 2,528 women) who underwent radical cystectomy for nonmetastatic UCUB. Temporal trend analyses, logistic regression models, cumulative incidence plots, competing-risks regression models and landmark analyses were used. Results: Overall, 2,454 men (28.4%) and 1,363 women (53.9%) were unmarried. Unmarried men had a higher rate of nonorgan-confined disease at radical cystectomy (OR: 1.24, CI 1.10–1.33; P < 0.001). Moreover, in men, unmarried status was an independent predictor of higher CSM (HR: 1.24, CI 1.12–1.37) In women, unmarried status neither predicted nonorgan-confined disease at radical cystectomy (OR: 1.07, CI 0.91–1.26; P = 0.37) nor was it associated with CSM (HR: 1.13, CI 0.88–1.31; P = 0.14). In 6-month landmark analyses, unmarried status remained an independent predictor of higher CSM in men (HR: 1.20, CI 1.08–1.33). Conclusions: Unmarried men have more advanced tumor stage at radical cystectomy and worse CSM compared to married men. Interestingly, marital status did not affect oncologic outcomes in women. These data suggest a gender-specific effect of marital status in UCUB. {\textcopyright} 2019 Elsevier Inc.",
keywords = "Bladder cancer, Epidemiology, Locally advanced disease, Marital status, SEER database, Survival, adult, aged, Article, bladder cancer, cancer patient, cancer surgery, cystectomy, female, human, lymph node dissection, major clinical study, male, marriage, middle aged, priority journal, single man, very elderly",
author = "G. Rosiello and C. Palumbo and S. Knipper and A. Pecoraro and C. Dzyuba-Negrean and S. Luzzago and Z. Tian and A. Gallina and F. Montorsi and S.F. Shariat and F. Saad and A. Briganti and P.I. Karakiewicz",
note = "Cited By :5 Export Date: 5 March 2021 CODEN: UOSOA Correspondence Address: Rosiello, G.; Cancer Prognostics and Health Outcomes Unit, Canada; email: giusepperosiello@hotmail.it Funding text 1: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. 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year = "2020",
doi = "10.1016/j.urolonc.2019.10.018",
language = "English",
volume = "38",
pages = "76.e1--76.e9",
journal = "Urol. Oncol. Semin. Orig. Invest.",
issn = "1078-1439",
publisher = "Elsevier Inc.",
number = "3",
}