Impact of marital status and race on outcomes of patients enrolled in Radiation Therapy Oncology Group prostate cancer trials
Introduction Previous studies by our group and others have demonstrated the importance of sociodemographic factors in cancer-related outcomes. The identification of these factors has led to novel approaches to the care of the high-risk cancer patient, specifically in the adoption of clinical interve...
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| Veröffentlicht in: | Supportive care in cancer 2012-06, Vol.20 (6), p.1317-1325 |
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| creator | Du, Kevin Lee Bae, Kyounghwa Movsas, Benjamin Yan, Yan Bryan, Charlene Bruner, Deborah Watkins |
| description | Introduction
Previous studies by our group and others have demonstrated the importance of sociodemographic factors in cancer-related outcomes. The identification of these factors has led to novel approaches to the care of the high-risk cancer patient, specifically in the adoption of clinical interventions that convey similar benefits as favorable sociodemographic characteristics. This study examined the importance of marital status and race as prognostic indicators in men with prostate cancer.
Methods
This report is a meta-analysis of 3,570 patients with prostate cancer treated in three prospective RTOG clinical trials. The Kaplan–Meier method was used to estimate the survival rate and the cumulative incidence method was used to analyze biochemical failure rate. Hazard ratios were calculated for all covariates using either the Cox or Fine and Gray’s proportional hazards model or logistic regression model with associated 95% confidence intervals and
p
values.
Results
Hazard ratio (HR) for overall survival (OS) for single status compared to married status was 1.36 (95% CI, 1.2 to 1.53). OS HR for non-White compared to White patients was 1.05 (CI 0.92 to 1.21). In contrast, the disease-free survival (DFS) HR and biochemical failure (BF) HR were both not significantly different neither between single and married patients nor between White patients and non-White patients. Median time to death for married men was 5.68 years and for single men was 4.73 years. Median time for DFS for married men was 7.25 years and for single men was 6.56 years. Median time for BF for married men was 7.81 years and for single men was 7.05 years.
Conclusions
Race was not associated with statistically significant differences in this analysis. Congruent with our previous work in other cancer sites, marital status predicted improved prostate cancer outcomes including overall survival.
Implications for cancer survivors
Prostate cancer is the most common visceral cancer in men in the USA. The stratification of prostate cancer risk is currently modeled solely on pathologic prognostic factors including PSA and Gleason Score. Independent of these pathologic prognostic factors, our paper describes the central sociodemographic factor of being single as a negative prognostic indicator. Single men are at high risk of poorer outcomes after prostate cancer treatment. Intriguingly, in our group of patients, race was not a significant prognostic factor. The findings in this paper add to the body of |
| doi_str_mv | 10.1007/s00520-011-1219-4 |
| format | Article |
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Previous studies by our group and others have demonstrated the importance of sociodemographic factors in cancer-related outcomes. The identification of these factors has led to novel approaches to the care of the high-risk cancer patient, specifically in the adoption of clinical interventions that convey similar benefits as favorable sociodemographic characteristics. This study examined the importance of marital status and race as prognostic indicators in men with prostate cancer.
Methods
This report is a meta-analysis of 3,570 patients with prostate cancer treated in three prospective RTOG clinical trials. The Kaplan–Meier method was used to estimate the survival rate and the cumulative incidence method was used to analyze biochemical failure rate. Hazard ratios were calculated for all covariates using either the Cox or Fine and Gray’s proportional hazards model or logistic regression model with associated 95% confidence intervals and
p
values.
Results
Hazard ratio (HR) for overall survival (OS) for single status compared to married status was 1.36 (95% CI, 1.2 to 1.53). OS HR for non-White compared to White patients was 1.05 (CI 0.92 to 1.21). In contrast, the disease-free survival (DFS) HR and biochemical failure (BF) HR were both not significantly different neither between single and married patients nor between White patients and non-White patients. Median time to death for married men was 5.68 years and for single men was 4.73 years. Median time for DFS for married men was 7.25 years and for single men was 6.56 years. Median time for BF for married men was 7.81 years and for single men was 7.05 years.
Conclusions
Race was not associated with statistically significant differences in this analysis. Congruent with our previous work in other cancer sites, marital status predicted improved prostate cancer outcomes including overall survival.
Implications for cancer survivors
Prostate cancer is the most common visceral cancer in men in the USA. The stratification of prostate cancer risk is currently modeled solely on pathologic prognostic factors including PSA and Gleason Score. Independent of these pathologic prognostic factors, our paper describes the central sociodemographic factor of being single as a negative prognostic indicator. Single men are at high risk of poorer outcomes after prostate cancer treatment. Intriguingly, in our group of patients, race was not a significant prognostic factor. The findings in this paper add to the body of work that describes important sociodemographic prognostic factors that are currently underappreciated in patients with cancer. Future steps will include the validation of these findings in prospective studies, and the incorporation of clinical strategies that identify and compensate for sociodemographic factors that predict for poorer cancer outcomes.</description><identifier>ISSN: 0941-4355</identifier><identifier>EISSN: 1433-7339</identifier><identifier>DOI: 10.1007/s00520-011-1219-4</identifier><identifier>PMID: 21720747</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Analysis ; Cancer ; Cancer patients ; Care and treatment ; Clinical trials ; Clinical Trials, Phase I as Topic ; Clinical Trials, Phase II as Topic ; Clinical Trials, Phase III as Topic ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Marital status ; Marital Status - statistics & numerical data ; Marriage ; Medical prognosis ; Medicine ; Medicine & Public Health ; Meta-analysis ; Middle Aged ; Nuclear radiation ; Nursing ; Nursing Research ; Oncology ; Original Article ; Pain Medicine ; Patient outcomes ; Prognosis ; Proportional Hazards Models ; Prostate cancer ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - radiotherapy ; Race ; Racial Groups - statistics & numerical data ; Radiotherapy ; Randomized Controlled Trials as Topic ; Rehabilitation Medicine ; Survival analysis ; Survival Rate ; Time Factors ; Treatment Failure ; Treatment Outcome</subject><ispartof>Supportive care in cancer, 2012-06, Vol.20 (6), p.1317-1325</ispartof><rights>Springer-Verlag 2011</rights><rights>COPYRIGHT 2012 Springer</rights><rights>Springer-Verlag 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-577cceb735a8a4dc78cb69d7610b01b815391cb104986359db8edf382d39dc453</citedby><cites>FETCH-LOGICAL-c439t-577cceb735a8a4dc78cb69d7610b01b815391cb104986359db8edf382d39dc453</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00520-011-1219-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00520-011-1219-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21720747$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Du, Kevin Lee</creatorcontrib><creatorcontrib>Bae, Kyounghwa</creatorcontrib><creatorcontrib>Movsas, Benjamin</creatorcontrib><creatorcontrib>Yan, Yan</creatorcontrib><creatorcontrib>Bryan, Charlene</creatorcontrib><creatorcontrib>Bruner, Deborah Watkins</creatorcontrib><title>Impact of marital status and race on outcomes of patients enrolled in Radiation Therapy Oncology Group prostate cancer trials</title><title>Supportive care in cancer</title><addtitle>Support Care Cancer</addtitle><addtitle>Support Care Cancer</addtitle><description>Introduction
Previous studies by our group and others have demonstrated the importance of sociodemographic factors in cancer-related outcomes. The identification of these factors has led to novel approaches to the care of the high-risk cancer patient, specifically in the adoption of clinical interventions that convey similar benefits as favorable sociodemographic characteristics. This study examined the importance of marital status and race as prognostic indicators in men with prostate cancer.
Methods
This report is a meta-analysis of 3,570 patients with prostate cancer treated in three prospective RTOG clinical trials. The Kaplan–Meier method was used to estimate the survival rate and the cumulative incidence method was used to analyze biochemical failure rate. Hazard ratios were calculated for all covariates using either the Cox or Fine and Gray’s proportional hazards model or logistic regression model with associated 95% confidence intervals and
p
values.
Results
Hazard ratio (HR) for overall survival (OS) for single status compared to married status was 1.36 (95% CI, 1.2 to 1.53). OS HR for non-White compared to White patients was 1.05 (CI 0.92 to 1.21). In contrast, the disease-free survival (DFS) HR and biochemical failure (BF) HR were both not significantly different neither between single and married patients nor between White patients and non-White patients. Median time to death for married men was 5.68 years and for single men was 4.73 years. Median time for DFS for married men was 7.25 years and for single men was 6.56 years. Median time for BF for married men was 7.81 years and for single men was 7.05 years.
Conclusions
Race was not associated with statistically significant differences in this analysis. Congruent with our previous work in other cancer sites, marital status predicted improved prostate cancer outcomes including overall survival.
Implications for cancer survivors
Prostate cancer is the most common visceral cancer in men in the USA. The stratification of prostate cancer risk is currently modeled solely on pathologic prognostic factors including PSA and Gleason Score. Independent of these pathologic prognostic factors, our paper describes the central sociodemographic factor of being single as a negative prognostic indicator. Single men are at high risk of poorer outcomes after prostate cancer treatment. Intriguingly, in our group of patients, race was not a significant prognostic factor. The findings in this paper add to the body of work that describes important sociodemographic prognostic factors that are currently underappreciated in patients with cancer. Future steps will include the validation of these findings in prospective studies, and the incorporation of clinical strategies that identify and compensate for sociodemographic factors that predict for poorer cancer outcomes.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Care and treatment</subject><subject>Clinical trials</subject><subject>Clinical Trials, Phase I as Topic</subject><subject>Clinical Trials, Phase II as Topic</subject><subject>Clinical Trials, Phase III as Topic</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Marital status</subject><subject>Marital Status - statistics & numerical data</subject><subject>Marriage</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Middle Aged</subject><subject>Nuclear radiation</subject><subject>Nursing</subject><subject>Nursing Research</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Pain Medicine</subject><subject>Patient outcomes</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Prostate cancer</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - radiotherapy</subject><subject>Race</subject><subject>Racial Groups - statistics & numerical data</subject><subject>Radiotherapy</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Rehabilitation Medicine</subject><subject>Survival analysis</subject><subject>Survival Rate</subject><subject>Time Factors</subject><subject>Treatment Failure</subject><subject>Treatment Outcome</subject><issn>0941-4355</issn><issn>1433-7339</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kU9vFSEUxYnR2Gf1A7gxJG7cTIUBhmHZNNo2adLE1DVh4M6TZgZGYBZv0e8uk1frn2hY3OTyu4fDPQi9peSMEiI_ZkJESxpCaUNbqhr-DO0oZ6yRjKnnaEcUpw1nQpygVznfE0KlFO1LdNJS2RLJ5Q49XM-LsQXHEc8m-WImnIspa8YmOJyMBRwDjmuxcYa8YYspHkLJGEKK0wQO-4C_GOdrv6J33yCZ5YBvg41T3B_wZYrrgpcUN13A1gQLCZfkzZRfoxdjLfDmsZ6ir58_3V1cNTe3l9cX5zeN5UyVRkhpLQySCdMb7qzs7dApJztKBkKHngqmqB0o4arvmFBu6MGNrG8dU85ywU7Rh6NutfF9hVz07LOFaTIB4po1rSukVU7yir7_C72PawrV3UYxzqVq6S9qbybQPoyx1F1tovqcCak6KTpWqbN_UPU4mL2NAUZf-38M0OOArevKCUa9JF9zOdS39Ra5Pkauq1-9Ra43w-8eDa_DDO5p4mfGFWiPQK5XYQ_p9x_9T_UHvy21aw</recordid><startdate>20120601</startdate><enddate>20120601</enddate><creator>Du, Kevin Lee</creator><creator>Bae, Kyounghwa</creator><creator>Movsas, Benjamin</creator><creator>Yan, Yan</creator><creator>Bryan, Charlene</creator><creator>Bruner, Deborah Watkins</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88J</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2R</scope><scope>M2S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20120601</creationdate><title>Impact of marital status and race on outcomes of patients enrolled in Radiation Therapy Oncology Group prostate cancer trials</title><author>Du, Kevin Lee ; Bae, Kyounghwa ; Movsas, Benjamin ; Yan, Yan ; Bryan, Charlene ; Bruner, Deborah Watkins</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-577cceb735a8a4dc78cb69d7610b01b815391cb104986359db8edf382d39dc453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis</topic><topic>Cancer</topic><topic>Cancer patients</topic><topic>Care and treatment</topic><topic>Clinical trials</topic><topic>Clinical Trials, Phase I as Topic</topic><topic>Clinical Trials, Phase II as Topic</topic><topic>Clinical Trials, Phase III as Topic</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Marital status</topic><topic>Marital Status - statistics & numerical data</topic><topic>Marriage</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Middle Aged</topic><topic>Nuclear radiation</topic><topic>Nursing</topic><topic>Nursing Research</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Pain Medicine</topic><topic>Patient outcomes</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Prostate cancer</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatic Neoplasms - radiotherapy</topic><topic>Race</topic><topic>Racial Groups - statistics & numerical data</topic><topic>Radiotherapy</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Rehabilitation Medicine</topic><topic>Survival analysis</topic><topic>Survival Rate</topic><topic>Time Factors</topic><topic>Treatment Failure</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Du, Kevin Lee</creatorcontrib><creatorcontrib>Bae, Kyounghwa</creatorcontrib><creatorcontrib>Movsas, Benjamin</creatorcontrib><creatorcontrib>Yan, Yan</creatorcontrib><creatorcontrib>Bryan, Charlene</creatorcontrib><creatorcontrib>Bruner, Deborah Watkins</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Sociology Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Social Science Database</collection><collection>Sociology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Supportive care in cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Du, Kevin Lee</au><au>Bae, Kyounghwa</au><au>Movsas, Benjamin</au><au>Yan, Yan</au><au>Bryan, Charlene</au><au>Bruner, Deborah Watkins</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of marital status and race on outcomes of patients enrolled in Radiation Therapy Oncology Group prostate cancer trials</atitle><jtitle>Supportive care in cancer</jtitle><stitle>Support Care Cancer</stitle><addtitle>Support Care Cancer</addtitle><date>2012-06-01</date><risdate>2012</risdate><volume>20</volume><issue>6</issue><spage>1317</spage><epage>1325</epage><pages>1317-1325</pages><issn>0941-4355</issn><eissn>1433-7339</eissn><abstract>Introduction
Previous studies by our group and others have demonstrated the importance of sociodemographic factors in cancer-related outcomes. The identification of these factors has led to novel approaches to the care of the high-risk cancer patient, specifically in the adoption of clinical interventions that convey similar benefits as favorable sociodemographic characteristics. This study examined the importance of marital status and race as prognostic indicators in men with prostate cancer.
Methods
This report is a meta-analysis of 3,570 patients with prostate cancer treated in three prospective RTOG clinical trials. The Kaplan–Meier method was used to estimate the survival rate and the cumulative incidence method was used to analyze biochemical failure rate. Hazard ratios were calculated for all covariates using either the Cox or Fine and Gray’s proportional hazards model or logistic regression model with associated 95% confidence intervals and
p
values.
Results
Hazard ratio (HR) for overall survival (OS) for single status compared to married status was 1.36 (95% CI, 1.2 to 1.53). OS HR for non-White compared to White patients was 1.05 (CI 0.92 to 1.21). In contrast, the disease-free survival (DFS) HR and biochemical failure (BF) HR were both not significantly different neither between single and married patients nor between White patients and non-White patients. Median time to death for married men was 5.68 years and for single men was 4.73 years. Median time for DFS for married men was 7.25 years and for single men was 6.56 years. Median time for BF for married men was 7.81 years and for single men was 7.05 years.
Conclusions
Race was not associated with statistically significant differences in this analysis. Congruent with our previous work in other cancer sites, marital status predicted improved prostate cancer outcomes including overall survival.
Implications for cancer survivors
Prostate cancer is the most common visceral cancer in men in the USA. The stratification of prostate cancer risk is currently modeled solely on pathologic prognostic factors including PSA and Gleason Score. Independent of these pathologic prognostic factors, our paper describes the central sociodemographic factor of being single as a negative prognostic indicator. Single men are at high risk of poorer outcomes after prostate cancer treatment. Intriguingly, in our group of patients, race was not a significant prognostic factor. The findings in this paper add to the body of work that describes important sociodemographic prognostic factors that are currently underappreciated in patients with cancer. Future steps will include the validation of these findings in prospective studies, and the incorporation of clinical strategies that identify and compensate for sociodemographic factors that predict for poorer cancer outcomes.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>21720747</pmid><doi>10.1007/s00520-011-1219-4</doi><tpages>9</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Analysis Cancer Cancer patients Care and treatment Clinical trials Clinical Trials, Phase I as Topic Clinical Trials, Phase II as Topic Clinical Trials, Phase III as Topic Follow-Up Studies Humans Kaplan-Meier Estimate Logistic Models Male Marital status Marital Status - statistics & numerical data Marriage Medical prognosis Medicine Medicine & Public Health Meta-analysis Middle Aged Nuclear radiation Nursing Nursing Research Oncology Original Article Pain Medicine Patient outcomes Prognosis Proportional Hazards Models Prostate cancer Prostatic Neoplasms - pathology Prostatic Neoplasms - radiotherapy Race Racial Groups - statistics & numerical data Radiotherapy Randomized Controlled Trials as Topic Rehabilitation Medicine Survival analysis Survival Rate Time Factors Treatment Failure Treatment Outcome |
| title | Impact of marital status and race on outcomes of patients enrolled in Radiation Therapy Oncology Group prostate cancer trials |
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