Patients with medullary thyroid carcinoma (MTC) who are married may have a better prognosis than patients who are unmarried, according to a new study published in Cancer Medicine.
Researchers found that married patients had statistically higher overall survival (OS; P =.00071) and cancer-specific survival (CSS; P =.013) rates compared to their unmarried counterparts, based on Kaplan-Meier survival curves.
Univariate Cox analysis revealed that marital status, sex, age, tumor stage, nodal stage, and type of surgery were all significant prognostic factors for OS and CSS (all P values <.05). When those factors were included in multivariate analysis, marital status was still found to be a significant factor for OS (P <.001) and CSS (P =.006).
Hazard ratios were worse for unmarried vs married patients: 2.15 (95% CI, 1.59-2.92) for OS and 1.70 (95% CI, 1.17-2.47) for CSS.
The study also identified a worse prognosis for older patients (aged 52 years and older) than younger patients in both OS and CSS (P <.001 for both). In the multivariate analysis, marital status did not have a significant effect in patients younger than 52 but did appear to increase survival for older patients in all subgroups (P <.05) except for M1 metastasis stage (OS, P =.101; CSS, P =.087).
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“These results showed that marriage had a significant protective effect in older patients among different pathological stages and its effect declined when the tumor progressed,” the authors said.
The authors hypothesized that the increased survival in married patients may be due to increased supervision from their spouse encouraging them to get tested and ultimately leading to an earlier diagnosis. They also said that increased income from their spouse may provide economic support for treatments.
Finally, they acknowledged that psychological support from a spouse may also help increase survival through a reduction in stress and anxiety that has been linked to cancer progression in other studies.
A total of 1344 patients with MTC were retrospectively included in the study. The patients were 60.7% female and had a mean age of 52.9 ± 15.5 years at the time of diagnosis. A total of 883 patients (65.8%) were married.
Ai L, Li N, Tan H-L, et al. Effects of marital status on survival of medullary thyroid cancer stratified by age. Cancer Med. Published online November 1, 2021. doi:10.1002/cam4.4388