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Reyngold M , Winter KA , Regine WF , Abrams RA , Safran H , Hoffman JP , Mowat RB , Hayes JP , Kessel IL , DiPetrillo T , Narayan S , Chen Y , Ben-Josef E , Delouya G , Suh JH , Meyer J , Haddock MG , Feldman M , Gaur R , Yost K , Peterson RA , Sherr DL , Moughan J , Crane CH
Marital Status and Overall Survival in Patients with Resectable Pancreatic Cancer: Results of an Ancillary Analysis of NRG Oncology/RTOG 9704
Oncologist. 2020 Mar;25(3) :e477-e483
PMID: 32162826    PMCID: PMC7066692   
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Abstract
BACKGROUND: Several registry-based analyses suggested a survival advantage for married versus single patients with pancreatic cancer. The mechanisms underlying the association of marital status and survival are likely multiple and complex and, therefore, may be obscured in analyses generated from large population-based databases. The goal of this research was to characterize this potential association of marital status with outcomes in patients with resected pancreatic cancer who underwent combined modality adjuvant therapy on a prospective clinical trial. MATERIALS AND METHODS: This is an ancillary analysis of 367 patients with known marital status treated on NRG Oncology/RTOG 97-04. Survival analysis was performed using the Kaplan-Meier method and compared using the log-rank test. Multivariate analysis was performed using the Cox proportional hazards regression model. RESULTS: Of 367 patients, 271 (74%) were married or partnered and 96 (26%) were single. Married or partnered patients were more likely to be male. There was no association between marital status and overall survival (OS) or disease-free survival (DFS) on univariate (hazard ratio [HR], 1.09 and 1.01, respectively) or multivariate analyses (HR, 1.05 and 0.98, respectively). Married or partnered male patients did not have improved survival compared with female or single patients. CONCLUSION: Ancillary analysis of data from NRG Oncology/RTOG 97-04 demonstrated no association between marital and/or partner status and OS or DFS in patients with resected pancreatic cancer who received adjuvant postoperative chemotherapy followed by concurrent external beam radiation therapy and chemotherapy. Clinical trial identification number. NCT00003216. IMPLICATIONS FOR PRACTICE: Several population-based studies have shown an epidemiological link between marital status and survival in patients with pancreatic cancer. A better understanding of this association could offer an opportunity to improve outcomes through psychosocial interventions designed to mitigate the negative effects of not being married. Based on the results of this analysis, patients who have undergone a resection and are receiving adjuvant therapy on a clinical trial are unlikely to benefit from such interventions. Further efforts to study the association between marital status and survival should be focused on less selected subgroups of patients with pancreatic cancer.
Notes
1549-490x Reyngold, Marsha Winter, Kathryn A Regine, William F Abrams, Ross A Safran, Howard Hoffman, John P Mowat, Rex B Hayes, John P Kessel, Ivan L DiPetrillo, Thomas Narayan, Samir Chen, Yuhchyau Ben-Josef, Edgar Delouya, Guila Suh, John H Meyer, Joshua Haddock, Michael G Feldman, Marvin Gaur, Rakesh Yost, Kathleen Peterson, Richard A Sherr, David L Moughan, Jennifer Crane, Christopher H UG1CA189867/CA/NCI NIH HHS/United States U10CA180868/CA/NCI NIH HHS/United States U10CA180822/CA/NCI NIH HHS/United States Journal Article United States Oncologist. 2020 Mar;25(3):e477-e483. doi: 10.1634/theoncologist.2019-0562. Epub 2019 Dec 16.