Effect of marital status on duodenal adenocarcinoma survival: A surveillance epidemiology and end results population analysis

Numerous studies have shown that marital status may be a prognostic factor in various malignancies, but little is known about its effect on duodenal adenocarcinoma. The aim of the present study was to determine the association between marital status and survival in patients with duodenal adenocarcinoma. The Surveillance, Epidemiology and End Results database was utilized to analyze 2,018 patients who had been diagnosed with duodenal adenocarcinoma between January 2004 and December 2015. Kaplan-Meier and Cox regression analyses were also used to determine the impact of marital status on overall survival (OS) and cause-specific survival (CSS). The 5-year OS rate was higher in married patients (32.6%) compared with unmarried (26.8%) patients (P<0.001), as was the 5-year CSS rate (38.8 vs. 33.7%; P<0.001). Multivariate analysis demonstrated that marital status was an independent prognostic factor for duodenal adenocarcinoma, with married patients having improved OS (P<0.001) and CSS (P=0.001) compared with unmarried patients. Subgroup analysis showed that marital status played a role in the survival of patients at American Joint Committee on Cancer Tumor-Node-Metastasis stage I, but not of patients at stages II, III or IV. The survival outcomes for duodenal adenocarcinoma are improved in married patients compared with those in unmarried patients. Therefore, attention should be paid to the impact of social factors and socio-economic factors on unmarried patients, in order to improve their survival outcomes.