Influence of marital status on small intestinal adenocarcinoma survival: an analysis of the Surveillance, Epidemiology, and End Results (SEER) database

Figures & data

Table 1 Comparison of clinicopathological features between married and unmarried patients with small intestinal adenocarcinoma

Characteristics	Unmarried N=2,885, n (%)	Married N=3,862, n (%)	P
Gender			<0.001
Male	1,139 (39.5)	2,517 (65.2)
Female	1,746 (60.5)	1,345 (34.8)
Age (years), mean ± SD	69.54±14.93	66.47±12.76	<0.001
Race			<0.001
White	2,040 (70.7)	3,095 (80.1)
Black	673 (23.3)	474 (12.3)
Othersa	172 (6.0)	293 (7.6)
Insurance			<0.001
Insured/Medicaid	2,138 (74.1)	2,891 (74.9)
Uninsured	93 (3.2)	64 (1.7)
Unknown	654 (22.7)	907 (23.4)
Tumor primary site			0.066
Duodenum	1,671 (57.9)	654 (58.7)
Jejunum	374 (13.0)	574 (14.9)
Ileum	370 (12.8)	475 (12.3)
Meckel’s diverticulum	5 (0.2)	4 (0.1)
Overlapping lesion of small intestine	38 (1.3)	43 (1.1)
Small intestine, NOS	427 (14.8)	498 (12.9)
AJCC seventh TNM stage			0.001
I	191 (6.6)	244 (6.3)
II	362 (12.5)	489 (12.7)
III	305 (10.6)	544 (14.1)
IV	524 (18.2)	665 (17.2)
Unknown/NA/blank(s)	1,503 (52.1)	1,920 (49.7)
AJCC seventh T stage			0.008
T0	7 (0.2)	6 (0.2)
T1	221 (7.7)	278 (7.2)
T2	65 (2.3)	119 (3.1)
T3	371 (12.9)	599 (15.5)
T4	564 (19.5)	750 (19.4)
TX/unknown/NA/blank(s)	1,657 (57.4)	2,110 (54.6)
AJCC seventh N stage			0.047
N0	845 (29.3)	1,082 (28.0)
N1	362 (12.5)	557 (14.4)
N2	173 (6.0)	266 (6.9)
NX/unknown/NA/blank(s)	1,505 (52.2)	1,957 (50.7)
AJCC seventh M stage			0.328
M0	1,024 (35.5)	1,433 (37.1)
M1	526 (18.2)	666 (17.2)
Blank(s)	1,335 (46.3)	1,763 (45.6)
Grade			0.012
Well differentiated	215 (7.5)	292 (7.6)
Moderately differentiated	1,174 (40.7)	1,629 (42.2)
Poorly differentiated	848 (29.4)	1,209 (31.3)
Undifferentiated/anaplastic	34 (1.2)	40 (1.0)
Unknown	614 (21.3)	692 (17.9)
Histology			0.676
Other adenocarcinoma	2,542 (88.1)	3,407 (88.2)
Mucinous adenocarcinoma	234 (8.1)	297 (7.7)
Signet ring cell	109 (3.8)	158 (4.1)
Surgery			<0.001
Yes	1,612 (55.9)	2,472 (64.0)
No	1,257 (43.6)	1,367 (35.4)
Unknown	16 (0.6)	23 (0.6)

Note:

a Including American Indian/AK native and Asian/Pacific Islander (N=448) and unknown race (N=17).

Abbreviations: AJCC, American Joint Committee on Cancer; NOS, not otherwise specified; NA, not applicable.

Table 2 Univariate and multivariate analyses of small intestinal adenocarcinoma OS

Characteristics	5-Year OS (%)	Univariate analysis		Multivariate analysis
		Log-rank χ^2 test	P	HR (95% CI)	P
Marital status		121.810	<0.001		<0.001
Unmarried	18.8			Reference
Married	27.1			0.789 (0.745–0.836)
Gender		0.023	0.879
Male	23.6
Female	23.6
Age (years)		387.401	<0.001		<0.001
<68	30.7			Reference
≥68	16.1			1.515 (1.426–1.610)
Race		0.421	0.810
White	24.0
Black	21.7
Othersa	23.3
Insurance		7.762	0.021		0.703
Insured/Medicaid	23.0			Reference
Uninsured	32.4			0.914 (0.740–1.128)
Unknown	24.0			0.998 (0.926–1.076)
Tumor primary site		325.506	<0.001		<0.001
Duodenum	18.2			Reference
Jejunum	38.6			0.829 (0.751–0.914)
Ileum	34.0			0.982 (0.887–1.088)
Meckel’s diverticulum	0			1.632 (0.730–3.646)
Overlapping lesion of small intestine	28.0			0.967 (0.732–1.276)
Small intestine, NOS	21.3			1.218 (1.114–1.331)
AJCC seventh TNM stage		626.818	<0.001		<0.001
I	38.1			Reference
II	41.0			1.011 (0.852–1.200
III	29.8			1.276 (1.080–1.508)
IV	4.6			1.923 (1.652–2.238)
Unknown/NA/blank(s)	22.1			1.460 (1.264–1.686)
Grade		399.771	<0.001		<0.001
Well differentiated	35.1			Reference
Moderately differentiated	29.8			1.096 (0.969–1.239)
Poorly differentiated	21.6			1.438 (1.268–1.631)
Undifferentiated/anaplastic	14.7			1.731 (1.296–2.312)
Unknown	0.9			1.102 (0.966–1.257)
Histology		28.093	<0.001		0.002
Other adenocarcinoma	23.8			Reference
Mucinous adenocarcinoma	27.3			1.042 (0.933–1.164)
Signet ring cell	12.0			1.287 (1.117–1.483)
Surgery		2,161.604	<0.001		<0.001
Yes	36.7			Reference
No	2.9			3.222 (2.983–3.480)
Unknown	23.8			1.731 (1.118–2.520)

Note:

a Including American Indian/AK native and Asian/Pacific Islander (N=448) and unknown race (N=17).

Abbreviations: AJCC, American Joint Committee on Cancer; NOS, not otherwise specified; OS, overall survival; NA, not applicable.

Figure 1 Overall survival in small intestinal adenocarcinoma according to marital status.

Table 3 Univariate and multivariate analyses of small intestinal adenocarcinoma CSS

Characteristics	5-Year CSS (%)	Univariate analysis		Multivariate analysis
		Log-rank χ^2 test	P	HR (95% CI)	P
Marital status		55.054	<0.001		<0.001
Unmarried	39.3			Reference
Married	45.7			0.794 (0.736–0.857)
Gender		1.392	0.238
Male	43.3
Female	42.7
Age (years)		63.046	<0.001		<0.001
<68	46.7			Reference
≥68	39.5			1.161 (1.075–1.254)
Race		2.885	0.236
White	44.1
Black	38.6
Othersa	41.8
Insurance		0.861	0.650
Insured/Medicaid	42.6
Uninsured	43.6
Unknown	43.6
Tumor primary site		240.334	<0.001		0.014
Duodenum	35.6			Reference
Jejunum	53.5			0.840 (0.741–0.951)
Ileum	57.0			0.851 (0.740–0.978)
Meckel’s diverticulum	0			2.207 (0.913–5.333)
Overlapping lesion of small intestine	46.5			0.897 (0.624–1.287)
Small intestine, NOS	48.7			0.967 (0.853–1.096)
AJCC seventh TNM stage		689.047	<0.001		<0.001
I	68.3			Reference
II	65.4			1.144 (0.880–1.489)
III	44.5			1.887 (1.475–2.413)
IV	11.1			3.191 (2.540–4.008)
Unknown/NA/blank(s)	42.4			1.995 (1.604–2.482)
Grade		360.890	<0.001		<0.001
Well differentiated	61.9			Reference
Moderately differentiated	51.3			1.194 (1.002–1.423)
Poorly differentiated	38.1			1.749 (1.464–2.090)
Undifferentiated/anaplastic	34.4			2.030 (1.387–2.971)
Unknown	22.0			1.290 (1.072–1.552)
Histology		24.234	<0.001		0.010
Other adenocarcinoma	43.3			Reference
Mucinous adenocarcinoma	48.6			1.070 (0.924–1.240)
Signet ring cell	24.6			1.312 (1.096–1.571)
Surgery		1,546.559	<0.001		<0.001
Yes	57.2			Reference
No	10.9			3.472 (3.138–3.841)
Unknown	44.7			1.321 (0.745–2.341)

Note:

a Including American Indian/AK native and Asian/Pacific Islander (N=448) and unknown race (N=17).

Abbreviations: AJCC, American Joint Committee on Cancer; CSS, cancer-specific survival; NOS, not otherwise specified.

Figure 2 Cancer-specific survival in small intestinal adenocarcinoma according to marital status.

Table 4 Marital status and small intestinal adenocarcinoma CSS

Marital status	n (%)	5-Year CSS (%)	Cox univariate analysis
			HR (95% CI)	P
Married (including common law)	3,862 (57.2)	45.7	Reference
Unmarried
Single (never married)	1,040 (15.4)	39.9	1.229 (1.107–1.366)	<0.001
Widowed	1,197 (17.7)	36.6	1.521 (1.376–1.682)	<0.001
Divorced	583 (8.6)	43.1	1.185 (1.035–1.356)	0.014
Separated	61 (0.9)	47.7	1.094 (0.737–1.652)	0.655
Unmarried or domestic partner	4 (0.1)	0	1.835 (0.459–7.347)	0.391

Abbreviation: CSS, cancer-specific survival.

Figure 3 Subgroup analysis of cancer-specific survival in small intestinal adenocarcinoma according to marital status.

Notes: (A) Surgery, P<0.001. (B) No surgery, P<0.001.