Can gallbladder cancer patients experience benefits from marriage? A competing risk analysis in a real-world context

Can gallbladder cancer patients experience benefits from marriage? 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A competing risk analysis in a real-world context Haimin Jin, Danwei Du, Yangyang Xie, Haijuan Jin, Jinfei Tong, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3972211/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: The association between marital status and gallbladder cancer (GBC) remains uncertain. This study aimed to verify the relationship between marital status and GBC and construct a prognostic nomogram to predict the impact of marital status on GBC patients. Method: GBC patients were split into married and unmarried groups and added to the Surveillance, Epidemiology, and End Results (SEER) database. We employed competing risk analyses, propensity score matching (PSM), and Kaplan-Meier survival analyses. After that, the relationship between marital status and GBC was verified and the predicted nomogram was constructed. Results: A cohort of 76 patients from Hangzhou Traditional Chinese Medicine (TCM) Hospital was selected as the external validation group, with an additional 3193 GBC patients obtained from the SEER database. Following PSM, both cohorts exhibited comparable 5-year cancer-specific survival rates. Notably, the results of the competing risk analysis unveiled a significant disparity in the 5-year cumulative incidence of cancer-specific death (CSD) between the two cohorts (59.1% vs. 65.2%, p = 0.003). Furthermore, the multivariate competing hazards regression analysis identified a noteworthy association (HR, 1.17; 95% CI, 1.04-1.31; p = 0.007) between marital status and CSD. To assess the 1-, 3-, and 5-year risks of CSD, a comprehensive competing event nomogram was constructed utilizing factors derived from the multivariate analysis. The area under the receiver operating characteristic curve (AUC) values for the 1-, 3-, and 5-year training cohorts were 0.806, 0.785, and 0.776, respectively. In the internal validation cohort, these values were 0.798, 0.790, and 0.790, while the external validation cohort exhibited AUC values of 0.748, 0.835, and 0.883 for the corresponding time intervals. Furthermore, calibration curves manifested a commendable level of concordance between the observed and predicted probabilities of CSD. Conclusion: Marital status offers potential benefits for GBC. Married GBC patients have better cancer-specific survival. The suggested nomogram demonstrates exceptional predictive power. SEER Program nomogram marital status gallbladder cancer competing risk analyses Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction Gallbladder cancer (GBC) stands as the predominant malignancy within the biliary tract, and its incidence is on an upward trajectory. 1 Despite its relatively infrequent occurrence, GBC ranks as the sixth most prevalent neoplasm within the digestive system. The prognosis for individuals diagnosed with GBC is notably grim, characterized by a median survival time of less than one year and a five-year overall survival (OS) rate falling below 5%. 1,2 Empirical investigations have elucidated a substantial influence of marital status on the survival outcomes of various malignancies, including colorectal, 3 gastric, 4 pancreatic, 5 hepatic, 6 and breast cancers. 7 In the context of primary mortality determinants, individuals in marital unions exhibit a more favorable prognosis and a diminished mortality rate compared to those who are single, separated, widowed, or divorced. 3,4,6 Furthermore, empirical evidence underscores the distinct role of marital status as an independent prognostic factor across diverse malignancies. 5,8–10 In a comprehensive nationwide randomized clinical trial led by Lee et al., encompassing 1,082 patients receiving integrated care and follow-up for stage III colon cancer, residing with alternative households and experiencing marital statuses of divorce, separation, or widowhood demonstrated robust associations with heightened mortality in colon cancer. 3 Additionally, the investigation by Li et al. revealed that within the initial 20 months post-stomach cancer diagnosis, individuals characterized by single marital status exhibited an elevated susceptibility to succumb to cancer-related causes. 4 Still, some studies examined the relationship between marital status and GBC, these observations suggest that the clinical outcomes of GBC patients are influenced by their marital status, with widowed individuals exhibiting an elevated likelihood of succumbing to the disease. 11–13 Nonetheless, a study conducted by Randi et al. posits that a substantive correlation between GBC risk and marital status is not discernible. 14 Thus, the relationship between marital status and GBC is still controversial. Our investigative approach incorporated competing risk analyses to scrutinize potential interferences posed by competing risks of mortality. Therefore, we conducted this study based on competing risk analysis to verify the relationship between marital status and GBC. The retrospective investigation was formulated to construct a predictive nomogram and scrutinize the potential influence of marital status on individuals afflicted with GBC, utilizing data from the Surveillance, Epidemiology, and End Results (SEER) database. Materials and methods Data source and patient selection During the interval from 2010 to 2015, pertinent patient data was extracted from the SEER 18 Regs Custom Data Set. Furthermore, for external validation, data encompassing the timeframe from January 2012 to December 2018 were obtained from the Hangzhou Traditional Chinese Medicine (TCM) Hospital. The inclusion criteria were defined as follows: Identification of GBC patients was carried out by the third edition of the International Classification of Diseases for Oncology (ICD-10:C23.051). Eligible patients were required to satisfy four specific conditions: (1) attainment of an age exceeding eighteen years; (2) GBC being their initial or sole cancer diagnosis; (3) a minimum survival duration of more than one month. Conversely, exclusion criteria encompassed patients with a history of other malignancies, those experiencing mortality from alternative cancers, and those with incomplete demographic, clinic-pathological, therapeutic, or follow-up data. Figure 1 elucidates the systematic procedure employed for patient selection. Clinicopathological variables Clinical parameters encompassed a spectrum of variables, incorporating marital status, age, gender, race, grade, American Joint Committee on Cancer (AJCC) stage, pathology, T stage, N stage, M stage, tumor size, surgery, radiotherapy, and chemotherapy. Marital status stratification involved categorization into married and unmarried groups, with the latter further subdivided into single, separated, divorced, and widowed. The conversion of the AJCC TNM staging system from the 7th to the 8th edition was executed in alignment with data sourced from the SEER database. Statistical analysis The chi-square test was used for comparing categorical variables. Kaplan-Meier survival analyses were employed to assess both OS and CSS. To thoroughly examine the potential influence of competing risk factors, the patient cohort was stratified into three distinct endpoints: survival, CSD, and OCD. Fine and Grey's proportional subdistribution hazard model was created, and cumulative incidence function analysis was executed using the R package "cmprsk." 15 Propensity score matching (PSM) emerges as a contemporary statistical methodology aimed at mitigating the impact of confounding variables in research. 16 Employing the nearest-neighbor technique, a 1:1 match ratio was established for patients within the married and single groups, with a 0.1 caliper applied. The research encompassed a comprehensive set of factors for matching purposes, incorporating age, gender, race, grade, AJCC stage, pathology, TNM stage, tumor size, surgery, radiotherapy, and chemotherapy. The standardized difference (SD) served as a metric to depict variations in variables pre- and after-PSM, with optimal balance achieved when SD ≤ 0.1 following matching. 17 Implementation of the PSM technique was executed utilizing the "Matching" R package. Subsequently, a randomized division assigned patients into two cohorts: a training set (50%) and a validation set (50%). Utilizing prognostic parameters inherent to the competing risk model, a 1-, 3-, and 5-year CSD nomogram was meticulously developed for the training dataset, drawing insights from Zhang's comprehensive study as a foundational reference. 18 The model's predictive performance underwent scrutiny via calibration plots and assessment of the area under the receiver operating characteristic curve (AUC) data. Calibration curves, generated through 1000 bootstrap resamples, facilitated a comparative analysis between observed and anticipated survival probabilities. Furthermore, receiver operating characteristic (ROC) curves were employed to compute AUC values, effectively illustrating the predictive prowess of the model. The R statistical analysis and visualization software, specifically version 4.0.3 (http://www.r-project.org), constituted the analytical framework for all investigations. Significance in statistical outcomes was determined by a two-tailed p-value of less than 0.05. Results From 2010 to 2015, the SEER database documented 3193 patients diagnosed with GBC, while the external validation cohort comprised 76 individuals from Hangzhou TCM Hospital. Among these patients, 1689 were identified as married, leaving 1504 categorized as unmarried. Substantive distinctions in age, gender, AJCC stage, N stage, M stage, as well as utilization of radiation and chemotherapy were discerned between the two cohorts (all p < 0.05). Notably, individuals in the married group exhibited higher proportions of receiving radiation and chemotherapy, elevated AJCC, N, and M stages, and a proclivity towards a younger age demographic. PSM was employed to mitigate the disparities in baseline data between the groups. The standardized differences (SD) for the majority of metrics, as illustrated in Figure S1, were consistently below 0.1, attesting to the efficacy of the balancing procedure. Ultimately, two cohorts, each comprising 2182 patients, were delineated: the married group (n = 1091) and the unmarried group (n = 1091). Comprehensive depictions of baseline characteristics before and after PSM are presented in Table 1 and Figure 1. Survival analysis Before implementing PSM, a marked dissimilarity in OS was observed between married and unmarried patient groups, although no discernible superiority in CSS was evident (Figures 2A and S2A). After the PSM application, a notable discrepancy in both OS and CSS emerged between the two cohorts (Figures 2C and S2C). Further stratification of non-married patients into widows, singles, separated individuals, and divorced individuals based on marital status revealed consistently superior OS and CSS outcomes for married patients compared to their unmarried counterparts, both pre-and post-PSM. Notably, widowed individuals exhibited the least favorable results (Figures 2B, 2D, S2B, and S2D). Cumulative incidence plots were systematically constructed, accounting for variables associated with competing risks. Among individuals lacking a spouse, a notably higher 5-year cumulative incidence of CSD (62.3% vs. 61.1%, p = 0.265) and a lower rate of OCD (11.9% vs. 16.0%, p < 0.001) were observed compared to their married counterparts (Table 2). Further subgroup analyses revealed a lack of significant correlation between marital status and CSD across various cohorts, except for the M1 subgroup, grade I, grade II, and instances with no chemotherapy (all p > 0.05). In the multivariable competing risks regression analysis, a statistically significant association between marital status and CSD was established (HR, 1.13; 95% CI,1.03-1.25; p = 0.012) (Table S1). Following a meticulous 1:1 PSM, the 5-year cumulative incidence of CSD exhibited a notable discrepancy between the two groups (59.1% vs. 65.2%, p = 0.003). Conversely, comparable 5-year cumulative incidences of OCD were observed in both cohorts (12.8% vs. 13.5%, p = 0.601) (Table 2). Figure 3 visually demonstrates that single patients manifested significantly elevated CSD rates in age, grade II, grade III, and surgery categories (all p < 0.05). In the multivariate competing risks regression analysis, a statistically significant association between marital status and CSD was affirmed (HR, 1.17; 95% CI, 1.04-1.31; p = 0.007) (Table S1). Univariate and multivariate analysis An additional independent analysis was undertaken, wherein patients were randomly assigned to two groups for the development of a prognostic model: a training cohort (50%, n = 1597) and a validation cohort (50%, n = 1596). Through univariate analysis, the 1-, 3-, and 5-year cumulative incidence function (CIF) values of CSD were determined in the training cohort. Variables such as tumor size, grade, T stage, N stage, and M stage, as well as chemotherapy and surgery, exhibited significant associations with CSD. Subsequently, the multivariate evaluation of the Fine-Gray proportional subdistribution hazards model was employed to identify crucial factors (p < 0.05). In the multivariate competing risk analysis, it was discerned that grade, T stage, N stage, M stage, tumor size, surgery, and chemotherapy independently predicted CSD in patients with GBC (Table 3). Constructing and verifying the nomogram After the multivariate analysis, a competing event nomogram was devised to ascertain the probabilities of CSD at 1, 3, and 5 years, integrating pertinent variables (Figure 4). Tumor size, grade, T stage, N stage, M stage, surgery, and chemotherapy were inclusively incorporated into the predictive model. The cumulative total points, derived by summing the scores corresponding to each patient's prognostic features, provide clinicians with a tool to assess the likelihood of CSD at distinct time intervals. Both internal and external validation cohorts were employed to assess the model's performance. In the training cohort, the 1-, 3-, and 5-year AUC values were 0.806, 0.785, and 0.776, respectively. Correspondingly, the internal validation cohort exhibited AUC values of 0.798, 0.790, and 0.790, while the external validation cohort demonstrated values of 0.748, 0.835, and 0.883. These results, depicted in Figures 5A-C, collectively underscore the model's robust discrimination ability. Calibration plots were employed to evaluate the model's prediction accuracy, revealing a commendable consistency between expected and observed probabilities of CSD across the three datasets (Figures 5D-F). The comprehensive findings affirm the strong predictability and high credibility of our developed nomogram. Discussion In this study, we performed competing risk analysis and Kaplan-Meier survival analysis utilizing data from 3193 GBC patients sourced from the SEER database. The results revealed that marital status conferred a survival benefit in terms of OS; however, its influence on CSS was not evident in these patients. The study underscores the significance of CSS as a more reliable metric for gauging the true impact of marital status, given that OS may be susceptible to confounding by OCD. 19 Additionally, the presence of OCD may introduce complexities in the accurate diagnosis of CSD. 20 Complementary competing risk analyses were also conducted to explore potential competing risks of mortality in this context. After a meticulous 1:1 PSM, a notable discrepancy emerged in the 5-year cumulative incidence of CSD between the two cohorts (59.1% vs. 65.2%, p = 0.003). Conversely, a comparable cumulative incidence of OCD was observed (12.8% vs. 13.5%, p = 0.601). In-depth subgroup analyses and multivariate competing hazards regression analysis substantiated a significant association between marital status and CSD. This suggests that the variance in OCD between the two groups may be partially explicable by unaccounted comorbidities not delineated in the SEER database and a lower prevalence of high-risk factors in the unmarried cohorts. It is noteworthy that prolonged survival times are inherently linked to an elevated risk of OCD, alongside other cancer types and cardiovascular conditions. We introduced a nomogram tailored to individual patient survival estimations, derived from the outcomes of competing risk analysis. The predictive model integrated grade, tumor size, surgery, chemotherapy, and T, N, M stages. Examination of the maximum points assigned to the amalgamated parameters identified T stage and grade as high-risk variables. Notably, prior research, such as the study conducted by Li et al., 13 has underscored the correlation between these risk factors and GBC. In his study, multivariate analysis employing Cox regression unveiled age, race, grade, histologic type, AJCC stage, SEER stage, and marital status as independent predictive factors for GBC survival. Moreover, Li et al.'s investigation on prognostic estimation for patients over 45 undergoing gallbladder adenocarcinoma resection identified seven independent survival predictors associated with OS. 21 These predictors, as determined by multivariate Cox regression analysis, encompassed age, marital status, grade, T stage, M stage, tumor size, and the logarithm of positive lymph nodes. We observed that the findings were fundamentally congruent, differing primarily in the variables included for analysis. Analogous to our study, the multivariate competing risk analysis delineated elevated tumor diameter, increased grade, advanced TNM stage, absence of treatment, and lack of surgery as independent risk factors for CSD. In comparison to the conventional multivariate regression model, the nomogram offered a graphical portrayal of the individual probabilities of 1-, 3-, and 5-year CSD. Furthermore, the model underwent validation in an independent cohort, affirming the robust reliability and commendable predictive capacity of our nomogram. Based on our findings, unmarried patients exhibited notably elevated CSD rates in the age, grade II, grade III, and surgical categories when compared to their married counterparts. Notably, at grade IV, there was no significant difference in CSD between the two groups (p = 0.515), possibly due to the relatively smaller sample size. Subsequent classification of unmarried patients into widowed, divorced, single, and separated groups revealed that widowed individuals experienced the lowest CSS. Our observations align with Song et al.'s investigation, 11 suggesting an increased risk of cancer-specific events among bereaved individuals and highlighting marital status as a predictive factor for clinical outcomes in GBC patients. Additionally, Bai et al.'s research further substantiates these findings, 12 indicating that bereaved patients exhibited lower 5-year CSS compared to individuals who were married, never married, or divorced/separated. Earlier investigations had established a correlation between marital status and cancer; however, the underlying mechanisms remained elusive. Married individuals exhibit a higher propensity to access standard healthcare and receive social support compared to their single counterparts. Hoskins KF et al.'s study on US women uncovered racial disparities in social determinants of health and markers indicative of aggressive tumor biology, including a genetic biomarker, elucidating the observed survival gap in early-stage, estrogen receptor-positive breast cancer. 22 Additionally, Coughlin SS's review highlighted the association of social variables with cancer-stage at survival. 23 Prolonged exposure to chronic stress has been demonstrated to induce alterations in the regulation of both the immunological and endocrine systems, consequently elevating the susceptibility to cancer and influencing survival rates. 24,25 Cortisol, commonly utilized as a biomarker, serves as a gauge for assessing the immune response and the functionality of the hypothalamic-pituitary-adrenal axis. 26,27 Notably, cancer patients benefiting from psychosocial support exhibit lower cortisol levels, thereby enhancing their prospects for survival. 28 Scholarly investigations suggest that the implementation of psychosocial therapies represents a promising avenue for enhancing immune-related health, given their consistent association with improved immune system functionality. 29 Marital union, as previously articulated, is considered a predominant reservoir of social support. The diminished survival outcomes observed in unmarried patients may be ascribed to the absence of psychological support inherent in marriage. Consequently, we posit that unmarried GBC patients necessitate heightened social support and psychological interventions. Limitation The study exhibits several limitations. Primarily, as is inherent in retrospective studies, the inevitability of selection bias constitutes a noteworthy constraint. Second, the nomogram was only applicable to patients who shared characteristics with the subjects of the propensity score analysis, according to the application of PSM. Additionally, the relatively modest size of the external validation sample underscores the imperative for supplementary external multicenter prospective validations. Conclusion By employing 1:1 PSM analysis and competing risk analysis, our study unveils potential advantages linked to marital status in GBC. Specifically, married GBC patients show increased CSS compared to those who are unmarried. The nomogram, showcasing significant predictive accuracy, aids in predicting individualized 1-, 3-, and 5-year CSD probabilities for these patients. Although our results hint at a positive marital influence, further validation through RCTs and additional investigations is crucial to solidify these conclusions. Declarations Ethics approval and consent to participate Given that the patient data sourced from the SEER database is publicly accessible, the necessity for ethical clearance was obviated. The Ethics Committee of Hangzhou TCM Hospital meticulously scrutinized and sanctioned the experiment involving human subjects. In compliance with national legislation and institutional guidelines, the procurement of written informed consent was deemed unnecessary for participation in this study. Competing interests As per the assertions of the authors, there existed no financial or commercial affiliations that could potentially give rise to a conflict of interest throughout the course of the study. Funding Funding for this research came from the Hangzhou Agricultural and Social Development Research Guide Project (20220919Y116) and the Science and Technology Program of Traditional Chinese Medicine in Zhejiang Province (2023ZL112). Availability of data and materials The datasets generated and analyzed in the course of this inquiry are accessible within the SEER database, accessible at https://seer.cancer.gov/. For further inquiries, the corresponding author can be reached for additional information. Acknowledgments Not applicable. Authors' contributions WJ-C, DW-D, and HM-J initiated and played pivotal roles in conceptualizing and designing the manuscript. JF-T, HJ-J and BB-L also contributed to the manuscript. 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Tables Table 1 The descriptive characteristics of gallbladder cancer patients before and after PSM Characteristics Before PSM P value After PSM P value All Married Unmarried All Married Unmarried N=3193 N=1689 N=1504 N=2182 N=1091 N=1091 Age: 65 2004 (62.8%) 979 (58.0%) 1025 (68.2%) 1319 (60.4%) 661 (60.6%) 658 (60.3%) ≤65 1189 (37.2%) 710 (42.0%) 479 (31.8%) 863 (39.6%) 430 (39.4%) 433 (39.7%) Gender: <0.001 0.66 Female 2202 (69.0%) 981 (58.1%) 1221 (81.2%) 1616 (74.1%) 803 (73.6%) 813 (74.5%) Male 991 (31.0%) 708 (41.9%) 283 (18.8%) 566 (25.9%) 288 (26.4%) 278 (25.5%) Race: 0.017 0.235 White 2458 (77.0%) 1329 (78.7%) 1129 (75.1%) 1702 (78.0%) 863 (79.1%) 839 (76.9%) Non White 735 (23.0%) 360 (21.3%) 375 (24.9%) 480 (22.0%) 228 (20.9%) 252 (23.1%) Grade: 0.094 0.94 I 474 (14.8%) 258 (15.3%) 216 (14.4%) 335 (15.4%) 168 (15.4%) 167 (15.3%) II 1408 (44.1%) 715 (42.3%) 693 (46.1%) 967 (44.3%) 477 (43.7%) 490 (44.9%) III 1232 (38.6%) 667 (39.5%) 565 (37.6%) 833 (38.2%) 423 (38.8%) 410 (37.6%) IV 79 (2.5%) 49 (2.9%) 30 (2.0%) 47 (2.2%) 23 (2.1%) 24 (2.2%) AJCC stage: 0.004 0.356 I 400 (12.5%) 220 (13.0%) 180 (12.0%) 295 (13.5%) 155 (14.2%) 140 (12.8%) II 868 (27.2%) 427 (25.3%) 441 (29.3%) 572 (26.2%) 297 (27.2%) 275 (25.2%) III 1093 (34.2%) 564 (33.4%) 529 (35.2%) 739 (33.9%) 366 (33.5%) 373 (34.2%) IV 832 (26.1%) 478 (28.3%) 354 (23.5%) 576 (26.4%) 273 (25.0%) 303 (27.8%) T stage: 0.731 0.7 T1 476 (14.9%) 262 (15.5%) 214 (14.2%) 352 (16.1%) 184 (16.9%) 168 (15.4%) T2 1342 (42.0%) 701 (41.5%) 641 (42.6%) 886 (40.6%) 447 (41.0%) 439 (40.2%) T3 1265 (39.6%) 670 (39.7%) 595 (39.6%) 863 (39.6%) 420 (38.5%) 443 (40.6%) T4 110 (3.4%) 56 (3.3%) 54 (3.6%) 81 (3.7%) 40 (3.7%) 41 (3.8%) N stage: <0.001 0.425 N0 2194 (68.7%) 1107 (65.5%) 1087 (72.3%) 1488 (68.2%) 756 (69.3%) 732 (67.1%) N1 860 (26.9%) 494 (29.2%) 366 (24.3%) 609 (27.9%) 297 (27.2%) 312 (28.6%) N2 139 (4.4%) 88 (5.2%) 51 (3.4%) 85 (3.9%) 38 (3.5%) 47 (4.3%) M stage: 0.005 0.199 M0 2490 (78.0%) 1284 (76.0%) 1206 (80.2%) 1694 (77.6%) 860 (78.8%) 834 (76.4%) M1 703 (22.0%) 405 (24.0%) 298 (19.8%) 488 (22.4%) 231 (21.2%) 257 (23.6%) Tumor size: 0.566 0.623 5cm 504 (15.8%) 269 (15.9%) 235 (15.6%) 339 (15.5%) 165 (15.1%) 174 (15.9%) Unknown 942 (29.5%) 506 (30.0%) 436 (29.0%) 664 (30.4%) 329 (30.2%) 335 (30.7%) Pathology: 0.566 0.387 Adenocarcinoma 2457 (76.9%) 1307 (77.4%) 1150 (76.5%) 1680 (77.0%) 849 (77.8%) 831 (76.2%) Others 736 (23.1%) 382 (22.6%) 354 (23.5%) 502 (23.0%) 242 (22.2%) 260 (23.8%) Surgery: 0.765 0.442 No 265 (8.3%) 143 (8.5%) 122 (8.1%) 185 (8.5%) 87 (8.0%) 98 (9.0%) Yes 2928 (91.7%) 1546 (91.5%) 1382 (91.9%) 1997 (91.5%) 1004 (92.0%) 993 (91.0%) Radiotherapy: <0.001 0.571 No 2620 (82.1%) 1335 (79.0%) 1285 (85.4%) 1805 (82.7%) 908 (83.2%) 897 (82.2%) Yes 573 (17.9%) 354 (21.0%) 219 (14.6%) 377 (17.3%) 183 (16.8%) 194 (17.8%) Chemotherapy: <0.001 0.177 No 1894 (59.3%) 903 (53.5%) 991 (65.9%) 1294 (59.3%) 663 (60.8%) 631 (57.8%) Yes 1299 (40.7%) 786 (46.5%) 513 (34.1%) 888 (40.7%) 428 (39.2%) 460 (42.2%) PSM propensity score matching Table 2 The cumulative incidence of CSD and OCD in two cohorts before and after PSM Cancer-specific death (%) P value Other causes death (%) P value 1-year CIF 3-year CIF 5-year CIF 1-year CIF 3-year CIF 5-year CIF Before PSM Married 0.353 0.562 0.611 0.265 0.054 0.096 0.119 <0.001 Unmarried 0.382 0.571 0.623 0.063 0.124 0.160 After PSM Married 0.345 0.548 0.591 0.003 0.054 0.102 0.128 0.601 Unmarried 0.387 0.593 0.652 0.062 0.107 0.135 CIF Cumulative incidences function Table 3 The cumulative incidences and multivariate subdistribution proportional hazards analysis on CSD Characteristics CSD (%) Subdistribution proportional hazards model 1-year CIF 3-year CIF 5-year CIF P value HR 95% CI P value Age >65 0.37 0.58 0.63 0.341 ≤65 0.34 0.56 0.61 Gender Female 0.36 0.56 0.61 0.619 Male 0.37 0.59 0.64 Race White 0.37 0.58 0.63 0.089 Non White 0.34 0.54 0.58 Marital status Married 0.34 0.56 0.61 0.148 Unmarried 0.39 0.58 0.63 Grade I 0.17 0.32 0.38 <0.001 Reference II 0.29 0.53 0.58 1.69 1.34-2.13 <0.001 III 0.50 0.69 0.74 2.35 1.85-2.99 <0.001 IV 0.57 0.78 0.80 4.09 2.69-6.2 <0.001 AJCC stage I 0.11 0.18 0.22 <0.001 II 0.14 0.37 0.43 III 0.38 0.65 0.71 IV 0.68 0.86 0.89 T stage T1 0.21 0.29 0.33 <0.001 Reference T2 0.22 0.46 0.53 1.51 1.17-1.95 0.001 T3 0.54 0.77 0.80 3.15 2.39-4.16 <0.001 T4 0.68 0.91 0.91 4.68 3.08-7.12 <0.001 N stage N0 0.31 0.50 0.55 <0.001 Reference N1 0.46 0.71 0.75 1.23 1.05-1.43 0.01 N2 0.63 0.85 0.87 1.25 0.92-1.71 0.156 M stage M0 0.26 0.49 0.55 <0.001 Reference M1 0.70 0.85 0.88 2.53 2.13-3.01 <0.001 Tumor size <2cm 0.18 0.37 0.43 <0.001 Reference 2-5cm 0.32 0.58 0.63 1.43 1.17-1.74 5cm 0.48 0.67 0.70 1.50 1.19-1.89 <0.001 Unknown 0.47 0.65 0.70 1.84 1.50-2.25 <0.001 Pathology Adenocarcinoma 0.34 0.56 0.61 0.092 Others 0.43 0.61 0.64 Surgery No 0.79 <0.001 Reference Yes 0.33 0.54 0.59 0.69 0.53-0.90 0.006 Radiotherapy No 0.39 0.56 0.61 0.565 Yes 0.23 0.60 0.65 Chemotherapy No 0.37 0.50 0.55 <0.001 Reference Yes 0.35 0.67 0.73 0.74 0.64-0.86 <0.001 HR hazard ratio Additional Declarations No competing interests reported. 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CSS of total (A) and subgroups (B) curves before PSM. CSS of total (C) and subgroups (D) curves after PSM.\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-3972211/v1/639db161b51e1190c58dd707.png"},{"id":51563740,"identity":"2fbbaeaf-0506-4614-8f84-d04071b07004","added_by":"auto","created_at":"2024-02-23 18:47:17","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":567114,"visible":true,"origin":"","legend":"\u003cp\u003eCumulative incidence curves for gallbladder cancer patientsin overall patients and subgroups after PSM. Overall patients (A), age ≤ 65 years (B), age \u0026gt; 65 years (C), grade I (D), grade II (E), grade III (F), grade IV (G), surgery no (H), surgery yes (I).\u003c/p\u003e","description":"","filename":"Figure3.png","url":"https://assets-eu.researchsquare.com/files/rs-3972211/v1/01167af7776d3cb1687229d4.png"},{"id":51563735,"identity":"032a8eb1-8c89-4c0d-a469-c5f2bea3452e","added_by":"auto","created_at":"2024-02-23 18:47:16","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":231607,"visible":true,"origin":"","legend":"\u003cp\u003eNomogram based on the competing risk analysis to predict CSD probabilities at 1-, 3-, and 5-year in gallbladder cancer patients.\u003c/p\u003e","description":"","filename":"Figure4.png","url":"https://assets-eu.researchsquare.com/files/rs-3972211/v1/e5e084380020c917c9eee125.png"},{"id":51563739,"identity":"3574fa82-d584-40ab-9b23-f93f843877e6","added_by":"auto","created_at":"2024-02-23 18:47:17","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":441792,"visible":true,"origin":"","legend":"\u003cp\u003eROC curves at the 1-, 3-, and 5-year points in the training (A), internal validation (B), and external validation cohort (C). Calibration curves at the 1-, 3-, and 5-year points in the training (D), internal validation (E), and external validation cohort (F).\u003c/p\u003e","description":"","filename":"Figure5.png","url":"https://assets-eu.researchsquare.com/files/rs-3972211/v1/1c6b6ce1a1a6e817948078ff.png"},{"id":51576018,"identity":"3cf86fe1-55a4-4bd9-94d7-383f4459598c","added_by":"auto","created_at":"2024-02-24 04:57:20","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1538292,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3972211/v1/c1ba6a89-4aa0-405a-919b-f7827a877e75.pdf"},{"id":51563738,"identity":"acc05f15-5a24-4504-997f-b43f8daf03f1","added_by":"auto","created_at":"2024-02-23 18:47:17","extension":"docx","order_by":10,"title":"","display":"","copyAsset":false,"role":"supplement","size":3343546,"visible":true,"origin":"","legend":"","description":"","filename":"supplementary.docx","url":"https://assets-eu.researchsquare.com/files/rs-3972211/v1/bdd7554d352004de6d11869b.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Can gallbladder cancer patients experience benefits from marriage? A competing risk analysis in a real-world context","fulltext":[{"header":"Introduction","content":"\u003cp\u003eGallbladder cancer (GBC) stands as the predominant malignancy within the biliary tract, and its incidence is on an upward trajectory.\u003csup\u003e1\u003c/sup\u003e Despite its relatively infrequent occurrence, GBC ranks as the sixth most prevalent neoplasm within the digestive system. The prognosis for individuals diagnosed with GBC is notably grim, characterized by a median survival time of less than one year and a five-year overall survival (OS) rate falling below 5%.\u003csup\u003e1,2\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eEmpirical investigations have elucidated a substantial influence of marital status on the survival outcomes of various malignancies, including colorectal,\u003csup\u003e3\u003c/sup\u003e\u003csup\u003e \u003c/sup\u003egastric,\u003csup\u003e4\u003c/sup\u003e pancreatic,\u003csup\u003e5\u003c/sup\u003e hepatic,\u003csup\u003e6\u003c/sup\u003e and breast cancers.\u003csup\u003e7\u003c/sup\u003e In the context of primary mortality determinants, individuals in marital unions exhibit a more favorable prognosis and a diminished mortality rate compared to those who are single, separated, widowed, or divorced.\u003csup\u003e3,4,6\u003c/sup\u003e \u003c/p\u003e\n\u003cp\u003eFurthermore, empirical evidence underscores the distinct role of marital status as an independent prognostic factor across diverse malignancies.\u003csup\u003e5,8\u0026ndash;10\u003c/sup\u003e In a comprehensive nationwide randomized clinical trial led by Lee et al., encompassing 1,082 patients receiving integrated care and follow-up for stage III colon cancer, residing with alternative households and experiencing marital statuses of divorce, separation, or widowhood demonstrated robust associations with heightened mortality in colon cancer.\u003csup\u003e3\u003c/sup\u003e Additionally, the investigation by Li et al. revealed that within the initial 20 months post-stomach cancer diagnosis, individuals characterized by single marital status exhibited an elevated susceptibility to succumb to cancer-related causes.\u003csup\u003e4\u003c/sup\u003e Still, some studies examined the relationship between marital status and GBC, these observations suggest that the clinical outcomes of GBC patients are influenced by their marital status, with widowed individuals exhibiting an elevated likelihood of succumbing to the disease.\u003csup\u003e11\u0026ndash;13\u003c/sup\u003e Nonetheless, a study conducted by Randi et al. posits that a substantive correlation between GBC risk and marital status is not discernible.\u003csup\u003e14\u003c/sup\u003e Thus, the relationship between marital status and GBC is still controversial. Our investigative approach incorporated competing risk analyses to scrutinize potential interferences posed by competing risks of mortality. Therefore, we conducted this study based on competing risk analysis to verify the relationship between marital status and GBC.\u003c/p\u003e\n\u003cp\u003eThe retrospective investigation was formulated to construct a predictive nomogram and scrutinize the potential influence of marital status on individuals afflicted with GBC, utilizing data from the Surveillance, Epidemiology, and End Results (SEER) database.\u003c/p\u003e"},{"header":"Materials and methods ","content":"\u003cp\u003e\u003cstrong\u003eData source and patient selection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDuring the interval from 2010 to 2015, pertinent patient data was extracted from the SEER 18 Regs Custom Data Set. Furthermore, for external validation, data encompassing the timeframe from January 2012 to December 2018 were obtained from the Hangzhou Traditional Chinese Medicine (TCM) Hospital.\u003c/p\u003e\n\u003cp\u003eThe inclusion criteria were defined as follows: Identification of GBC patients was carried out by the third edition of the International Classification of Diseases for Oncology (ICD-10:C23.051). Eligible patients were required to satisfy four specific conditions: (1) attainment of an age exceeding eighteen years; (2) GBC being their initial or sole cancer diagnosis; (3) a minimum survival duration of more than one month. Conversely, exclusion criteria encompassed patients with a history of other malignancies, those experiencing mortality from alternative cancers, and those with incomplete demographic, clinic-pathological, therapeutic, or follow-up data. Figure 1 elucidates the systematic procedure employed for patient selection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinicopathological variables\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eClinical parameters encompassed a spectrum of variables, incorporating marital status, age, gender, race, grade, American Joint Committee on Cancer (AJCC) stage, pathology, T stage, N stage, M stage, tumor size, surgery, radiotherapy, and chemotherapy. Marital status stratification involved categorization into married and unmarried groups, with the latter further subdivided into single, separated, divorced, and widowed. The conversion of the AJCC TNM staging system from the 7th to the 8th edition was executed in alignment with data sourced from the SEER database.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe chi-square test was used for comparing categorical variables. Kaplan-Meier survival analyses were employed to assess both OS and CSS. To thoroughly examine the potential influence of competing risk factors, the patient cohort was stratified into three distinct endpoints: survival, CSD, and OCD. Fine and Grey\u0026apos;s proportional subdistribution hazard model was created, and cumulative incidence function analysis was executed using the R package \u0026quot;cmprsk.\u0026quot;\u003csup\u003e15\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003ePropensity score matching (PSM) emerges as a contemporary statistical methodology aimed at mitigating the impact of confounding variables in research.\u003csup\u003e16\u003c/sup\u003e Employing the nearest-neighbor technique, a 1:1 match ratio was established for patients within the married and single groups, with a 0.1 caliper applied. The research encompassed a comprehensive set of factors for matching purposes, incorporating\u0026nbsp;age, gender, race, grade, AJCC stage, pathology, TNM stage, tumor size, surgery, radiotherapy, and chemotherapy. The standardized difference (SD) served as a metric to depict variations in variables pre- and after-PSM, with optimal balance achieved when SD \u0026le; 0.1 following matching.\u003csup\u003e17\u003c/sup\u003e Implementation of the PSM technique was executed utilizing the \u0026quot;Matching\u0026quot; R package.\u003c/p\u003e\n\u003cp\u003eSubsequently, a randomized division assigned patients into two cohorts: a training set (50%) and a validation set (50%). Utilizing prognostic parameters inherent to the competing risk model, a 1-, 3-, and 5-year CSD nomogram was meticulously developed for the training dataset, drawing insights from Zhang\u0026apos;s comprehensive study as a foundational reference.\u003csup\u003e18\u003c/sup\u003e The model\u0026apos;s predictive performance underwent scrutiny via calibration plots and assessment of the area under the receiver operating characteristic curve (AUC) data. Calibration curves, generated through 1000 bootstrap resamples, facilitated a comparative analysis between observed and anticipated survival probabilities. Furthermore, receiver operating characteristic (ROC) curves were employed to compute AUC values, effectively illustrating the predictive prowess of the model.\u003c/p\u003e\n\u003cp\u003eThe R statistical analysis and visualization software, specifically version 4.0.3 (http://www.r-project.org), constituted the analytical framework for all investigations. Significance in statistical outcomes was determined by a two-tailed p-value of less than 0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eFrom 2010 to 2015, the SEER database documented 3193 patients diagnosed with GBC, while the external validation cohort comprised 76 individuals from Hangzhou TCM Hospital. Among these patients, 1689 were identified as married, leaving 1504 categorized as unmarried. Substantive distinctions in age, gender, AJCC stage, N stage, M stage, as well as utilization of radiation and chemotherapy were discerned between the two cohorts (all p \u0026lt; 0.05). Notably, individuals in the married group exhibited higher proportions of receiving radiation and chemotherapy, elevated AJCC, N, and M stages, and a proclivity towards a younger age demographic.\u003c/p\u003e\n\u003cp\u003ePSM was employed to mitigate the disparities in baseline data between the groups. The standardized differences (SD) for the majority of metrics, as illustrated in Figure S1, were consistently below 0.1, attesting to the efficacy of the balancing procedure. Ultimately, two cohorts, each comprising 2182 patients, were delineated: the married group (n = 1091) and the unmarried group (n = 1091). Comprehensive depictions of baseline characteristics before and after PSM are presented in Table 1 and Figure 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSurvival analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBefore implementing PSM, a marked dissimilarity in OS was observed between married and unmarried patient groups, although no discernible superiority in CSS was evident (Figures 2A and S2A). After the PSM application, a notable discrepancy in both OS and CSS emerged between the two cohorts (Figures 2C and S2C). Further stratification of non-married patients into widows, singles, separated individuals, and divorced individuals based on marital status revealed consistently superior OS and CSS outcomes for married patients compared to their\u0026nbsp;unmarried\u0026nbsp;counterparts, both pre-and post-PSM. Notably, widowed individuals exhibited the least favorable results (Figures 2B, 2D, S2B, and S2D).\u003c/p\u003e\n\u003cp\u003eCumulative incidence plots were systematically constructed, accounting for variables associated with competing risks. Among individuals lacking a spouse, a notably higher 5-year cumulative incidence of CSD (62.3% vs. 61.1%, p = 0.265) and a lower rate of OCD (11.9% vs. 16.0%, p \u0026lt; 0.001) were observed compared to their married counterparts (Table 2). Further subgroup analyses revealed a lack of significant correlation between marital status and CSD across various cohorts, except for the M1 subgroup, grade I, grade II, and instances with no chemotherapy (all p \u0026gt; 0.05). In the multivariable competing risks regression analysis, a statistically significant association between marital status and CSD was established (HR, 1.13; 95% CI,1.03-1.25; p = 0.012) (Table S1).\u003c/p\u003e\n\u003cp\u003eFollowing a meticulous 1:1 PSM, the 5-year cumulative incidence of CSD exhibited a notable discrepancy between the two groups (59.1% vs. 65.2%, p = 0.003). Conversely, comparable 5-year cumulative incidences of OCD were observed in both cohorts (12.8% vs. 13.5%, p = 0.601) (Table 2). Figure 3 visually demonstrates that single patients manifested significantly elevated CSD rates in age, grade II, grade III, and surgery categories (all p \u0026lt; 0.05). In the multivariate competing risks regression analysis, a statistically significant association between marital status and CSD was affirmed (HR, 1.17; 95% CI, 1.04-1.31; p = 0.007) (Table S1).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eUnivariate and multivariate analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAn additional independent analysis was undertaken, wherein patients were randomly assigned to two groups for the development of a prognostic model: a training cohort (50%, n = 1597) and a validation cohort (50%, n = 1596). Through univariate analysis, the 1-, 3-, and 5-year cumulative incidence function (CIF) values of CSD were determined in the training cohort. Variables such as tumor size, grade, T stage, N stage, and M stage, as well as chemotherapy and surgery, exhibited significant associations with CSD. Subsequently, the multivariate evaluation of the Fine-Gray proportional subdistribution hazards model was employed to identify crucial factors (p \u0026lt; 0.05). In the multivariate competing risk analysis, it was discerned that grade, T stage, N stage, M stage, tumor size, surgery, and chemotherapy independently predicted CSD in patients with GBC (Table 3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConstructing and verifying the nomogram\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAfter the multivariate analysis, a competing event nomogram was devised to ascertain the probabilities of CSD at 1, 3, and 5 years, integrating pertinent variables (Figure 4). Tumor size, grade, T stage, N stage, M stage, surgery, and chemotherapy were inclusively incorporated into the predictive model. The cumulative total points, derived by summing the scores corresponding to each patient\u0026apos;s prognostic features, provide clinicians with a tool to assess the likelihood of CSD at distinct time intervals.\u003c/p\u003e\n\u003cp\u003eBoth internal and external validation cohorts were employed to assess the model\u0026apos;s performance. In the training cohort, the 1-, 3-, and 5-year AUC values were 0.806, 0.785, and 0.776, respectively. Correspondingly, the internal validation cohort exhibited AUC values of 0.798, 0.790, and 0.790, while the external validation cohort demonstrated values of 0.748, 0.835, and 0.883. These results, depicted in Figures 5A-C, collectively underscore the model\u0026apos;s robust discrimination ability. Calibration plots were employed to evaluate the model\u0026apos;s prediction accuracy, revealing a commendable consistency between expected and observed probabilities of CSD across the three datasets (Figures 5D-F). The comprehensive findings affirm the strong predictability and high credibility of our developed nomogram.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, we performed competing risk analysis and Kaplan-Meier survival analysis utilizing data from 3193 GBC patients sourced from the SEER database. The results revealed that marital status conferred a survival benefit in terms of OS; however, its influence on CSS was not evident in these patients. The study underscores the significance of CSS as a more reliable metric for gauging the true impact of marital status, given that OS may be susceptible to confounding by OCD.\u003csup\u003e19\u003c/sup\u003e Additionally, the presence of OCD may introduce complexities in the accurate diagnosis of CSD.\u003csup\u003e20\u003c/sup\u003e Complementary competing risk analyses were also conducted to explore potential competing risks of mortality in this context. After a meticulous 1:1 PSM, a notable discrepancy emerged in the 5-year cumulative incidence of CSD between the two cohorts (59.1% vs. 65.2%, p = 0.003). Conversely, a comparable cumulative incidence of OCD was observed (12.8% vs. 13.5%, p = 0.601). In-depth subgroup analyses and multivariate competing hazards regression analysis substantiated a significant association between marital status and CSD. This suggests that the variance in OCD between the two groups may be partially explicable by unaccounted comorbidities not delineated in the SEER database and a lower prevalence of high-risk factors in the unmarried cohorts. It is noteworthy that prolonged survival times are inherently linked to an elevated risk of OCD, alongside other cancer types and cardiovascular conditions.\u003c/p\u003e\n\u003cp\u003eWe introduced a nomogram tailored to individual patient survival estimations, derived from the outcomes of competing risk analysis. The predictive model integrated grade, tumor size, surgery, chemotherapy, and T, N, M stages. Examination of the maximum points assigned to the amalgamated parameters identified T stage and grade as high-risk variables. Notably, prior research, such as the study conducted by Li et al.,\u003csup\u003e13\u003c/sup\u003e has underscored the correlation between these risk factors and GBC. In his study, multivariate analysis employing Cox regression unveiled age, race, grade, histologic type, AJCC stage, SEER stage, and marital status as independent predictive factors for GBC survival. Moreover, Li et al.\u0026apos;s investigation on prognostic estimation for patients over 45 undergoing gallbladder adenocarcinoma resection identified seven independent survival predictors associated with OS.\u003csup\u003e21\u003c/sup\u003e These predictors, as determined by multivariate Cox regression analysis, encompassed age, marital status, grade, T stage, M stage, tumor size, and the logarithm of positive lymph nodes. We observed that the findings were fundamentally congruent, differing primarily in the variables included for analysis. Analogous to our study, the multivariate competing risk analysis delineated elevated tumor diameter, increased grade, advanced TNM stage, absence of treatment, and lack of surgery as independent risk factors for CSD. In comparison to the conventional multivariate regression model, the nomogram offered a graphical portrayal of the individual probabilities of 1-, 3-, and 5-year CSD. Furthermore, the model underwent validation in an independent cohort, affirming the robust reliability and commendable predictive capacity of our nomogram.\u003c/p\u003e\n\u003cp\u003eBased on our findings, unmarried patients exhibited notably elevated CSD rates in the age, grade II, grade III, and surgical categories when compared to their married counterparts. Notably, at grade IV, there was no significant difference in CSD between the two groups (p = 0.515), possibly due to the relatively smaller sample size. Subsequent classification of unmarried patients into widowed, divorced, single, and separated groups revealed that widowed individuals experienced the lowest CSS. Our observations align with Song et al.\u0026apos;s investigation,\u003csup\u003e11\u003c/sup\u003e suggesting an increased risk of cancer-specific events among bereaved individuals and highlighting marital status as a predictive factor for clinical outcomes in GBC patients. Additionally, Bai et al.\u0026apos;s research further substantiates these findings,\u003csup\u003e12\u003c/sup\u003e indicating that bereaved patients exhibited lower 5-year CSS compared to individuals who were married, never married, or divorced/separated.\u003c/p\u003e\n\u003cp\u003eEarlier investigations had established a correlation between marital status and cancer; however, the underlying mechanisms remained elusive. Married individuals exhibit a higher propensity to access standard healthcare and receive social support compared to their single counterparts. Hoskins KF et al.\u0026apos;s study on US women uncovered racial disparities in social determinants of health and markers indicative of aggressive tumor biology, including a genetic biomarker, elucidating the observed survival gap in early-stage, estrogen receptor-positive breast cancer.\u003csup\u003e22\u003c/sup\u003e Additionally, Coughlin SS\u0026apos;s review highlighted the association of social variables with cancer-stage at survival.\u003csup\u003e23\u003c/sup\u003e Prolonged exposure to chronic stress has been demonstrated to induce alterations in the regulation of both the immunological and endocrine systems, consequently elevating the susceptibility to cancer and influencing survival rates.\u003csup\u003e24,25\u003c/sup\u003e Cortisol, commonly utilized as a biomarker, serves as a gauge for assessing the immune response and the functionality of the hypothalamic-pituitary-adrenal axis.\u003csup\u003e26,27\u003c/sup\u003e Notably, cancer patients benefiting from psychosocial support exhibit lower cortisol levels, thereby enhancing their prospects for survival.\u003csup\u003e28\u003c/sup\u003e Scholarly investigations suggest that the implementation of psychosocial therapies represents a promising avenue for enhancing immune-related health, given their consistent association with improved immune system functionality.\u003csup\u003e29\u003c/sup\u003e Marital union, as previously articulated, is considered a predominant reservoir of social support. The diminished survival outcomes observed in unmarried patients may be ascribed to the absence of psychological support inherent in marriage. Consequently, we posit that unmarried GBC patients necessitate heightened social support and psychological interventions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study exhibits several limitations. Primarily, as is inherent in retrospective studies, the inevitability of selection bias constitutes a noteworthy constraint. Second, the nomogram was only applicable to patients who shared characteristics with the subjects of the propensity score analysis, according to the application of PSM. Additionally, the relatively modest size of the external validation sample underscores the imperative for supplementary external multicenter prospective validations.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eBy employing 1:1 PSM analysis and competing risk analysis, our study unveils potential advantages linked to marital status in GBC. Specifically, married GBC patients show increased CSS compared to those who are unmarried. The nomogram, showcasing significant predictive accuracy, aids in predicting individualized 1-, 3-, and 5-year CSD probabilities for these patients. Although our results hint at a positive marital influence, further validation through RCTs and additional investigations is crucial to solidify these conclusions.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eGiven that the patient data sourced from the SEER database is publicly accessible, the necessity for ethical clearance was obviated. The Ethics Committee of Hangzhou TCM Hospital meticulously scrutinized and sanctioned the experiment involving human subjects. In compliance with national legislation and institutional guidelines, the procurement of written informed consent was deemed unnecessary for participation in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs per the assertions of the authors, there existed no financial or commercial affiliations that could potentially give rise to a conflict of interest throughout the course of the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFunding for this research came from the Hangzhou Agricultural and Social Development Research Guide Project (20220919Y116) and the Science and Technology Program of Traditional Chinese Medicine in Zhejiang Province (2023ZL112).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and analyzed in the course of this inquiry are accessible within the SEER database, accessible at https://seer.cancer.gov/. For further inquiries, the corresponding author can be reached for additional information.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWJ-C, DW-D, and HM-J initiated and played pivotal roles in conceptualizing and designing the manuscript. JF-T, HJ-J and BB-L also contributed to the manuscript. Statistical analysis and database organization were handled by YY-X. Each author thoroughly reviewed and approved the submitted version of the paper, actively participating in the editing process.\u003c/p\u003e"},{"header":"Reference","content":"\u003col\u003e\n\u003cli\u003eHundal, R. \u0026amp; Shaffer, E. A. Gallbladder cancer: epidemiology and outcome. \u003cem\u003eClin. 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Psychosocial Interventions and Immune System Function: A Systematic Review and Meta-analysis of Randomized Clinical Trials. \u003cem\u003eJAMA Psychiatry\u003c/em\u003e \u003cstrong\u003e77\u003c/strong\u003e, 1031\u0026ndash;1043 (2020).\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1\u003c/strong\u003e The descriptive characteristics of gallbladder cancer patients before and after PSM\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 105px;\" rowspan=\"3\"\u003e\n\u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" colspan=\"3\"\u003e\n\u003cp\u003e\u003cstrong\u003eBefore PSM\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 105px;\" rowspan=\"3\"\u003e\n\u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" colspan=\"3\"\u003e\n\u003cp\u003e\u003cstrong\u003eAfter PSM\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 105px;\" rowspan=\"3\"\u003e\n\u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;All\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u003cstrong\u003eMarried\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Unmarried\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;All\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u003cstrong\u003eMarried\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u003cstrong\u003eUnmarried\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u003cstrong\u003eN=3193 \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u003cstrong\u003eN=1689\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u003cstrong\u003eN=1504\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u003cstrong\u003eN=2182\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u003cstrong\u003eN=1091\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;N=1091\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003eAge:\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026lt;0.001 \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.93\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026gt;65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e2004 (62.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;979 (58.0%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1025 (68.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1319 (60.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;661 (60.6%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e658 (60.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026le;65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1189 (37.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;710 (42.0%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e479 (31.8%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e863 (39.6%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;430 (39.4%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e433 (39.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003eGender:\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026lt;0.001 \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.66\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Female\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e2202 (69.0%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;981 (58.1%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1221 (81.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1616 (74.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;803 (73.6%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e813 (74.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Male\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e991 (31.0%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;708 (41.9%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e283 (18.8%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e566 (25.9%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;288 (26.4%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e278 (25.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003eRace:\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.017\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.235\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; White\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e2458 (77.0%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1329 (78.7%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1129 (75.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1702 (78.0%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;863 (79.1%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e839 (76.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Non White\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e735 (23.0%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;360 (21.3%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e375 (24.9%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e480 (22.0%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;228 (20.9%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e252 (23.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003eGrade:\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.094\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.94\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; I\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e474 (14.8%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;258 (15.3%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e216 (14.4%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e335 (15.4%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;168 (15.4%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e167 (15.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; II\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1408 (44.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;715 (42.3%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e693 (46.1%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e967 (44.3%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;477 (43.7%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e490 (44.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; III\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1232 (38.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;667 (39.5%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e565 (37.6%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e833 (38.2%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;423 (38.8%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e410 (37.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; IV\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;79 (2.5%) \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; 49 (2.9%) \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;30 (2.0%) \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;47 (2.2%) \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; 23 (2.1%) \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;24 (2.2%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003eAJCC stage:\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.004\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.356\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; I\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e400 (12.5%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;220 (13.0%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e180 (12.0%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e295 (13.5%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;155 (14.2%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e140 (12.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; II\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e868 (27.2%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;427 (25.3%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e441 (29.3%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e572 (26.2%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;297 (27.2%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e275 (25.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; III\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1093 (34.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;564 (33.4%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e529 (35.2%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e739 (33.9%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;366 (33.5%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e373 (34.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; IV\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e832 (26.1%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;478 (28.3%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e354 (23.5%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e576 (26.4%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;273 (25.0%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e303 (27.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003eT stage:\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.731\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.7\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; T1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e476 (14.9%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;262 (15.5%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e214 (14.2%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e352 (16.1%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;184 (16.9%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e168 (15.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; T2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1342 (42.0%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;701 (41.5%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e641 (42.6%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e886 (40.6%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;447 (41.0%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e439 (40.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; T3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1265 (39.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;670 (39.7%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e595 (39.6%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e863 (39.6%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;420 (38.5%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e443 (40.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; T4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;110 (3.4%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; 56 (3.3%) \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;54 (3.6%) \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;81 (3.7%) \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; 40 (3.7%) \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;41 (3.8%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003eN stage:\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026lt;0.001 \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.425\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; N0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e2194 (68.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1107 (65.5%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1087 (72.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1488 (68.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;756 (69.3%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e732 (67.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; N1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e860 (26.9%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;494 (29.2%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e366 (24.3%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e609 (27.9%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;297 (27.2%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e312 (28.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; N2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;139 (4.4%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; 88 (5.2%) \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;51 (3.4%) \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;85 (3.9%) \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; 38 (3.5%) \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;47 (4.3%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003eM stage:\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.005\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.199\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; M0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e2490 (78.0%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1284 (76.0%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1206 (80.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1694 (77.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;860 (78.8%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e834 (76.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; M1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e703 (22.0%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;405 (24.0%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e298 (19.8%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e488 (22.4%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;231 (21.2%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e257 (23.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003eTumor size:\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.566\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.623\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026lt;2cm\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e689 (21.6%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;348 (20.6%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e341 (22.7%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e471 (21.6%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;248 (22.7%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e223 (20.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; 2-5cm\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1058 (33.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;566 (33.5%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e492 (32.7%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e708 (32.4%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;349 (32.0%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e359 (32.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026gt;5cm\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e504 (15.8%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;269 (15.9%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e235 (15.6%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e339 (15.5%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;165 (15.1%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e174 (15.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Unknown\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e942 (29.5%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;506 (30.0%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e436 (29.0%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e664 (30.4%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;329 (30.2%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e335 (30.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003ePathology:\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.566\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.387\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Adenocarcinoma\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e2457 (76.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1307 (77.4%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1150 (76.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1680 (77.0%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;849 (77.8%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e831 (76.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Others\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e736 (23.1%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;382 (22.6%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e354 (23.5%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e502 (23.0%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;242 (22.2%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e260 (23.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003eSurgery:\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.765\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.442\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; No\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;265 (8.3%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;143 (8.5%) \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;122 (8.1%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;185 (8.5%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; 87 (8.0%) \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;98 (9.0%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Yes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e2928 (91.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1546 (91.5%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1382 (91.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1997 (91.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1004 (92.0%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e993 (91.0%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003eRadiotherapy:\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026lt;0.001 \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.571\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; No\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e2620 (82.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1335 (79.0%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1285 (85.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1805 (82.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;908 (83.2%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e897 (82.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Yes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e573 (17.9%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;354 (21.0%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e219 (14.6%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e377 (17.3%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;183 (16.8%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e194 (17.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003eChemotherapy:\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026lt;0.001 \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e0.177\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; No\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1894 (59.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;903 (53.5%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e991 (65.9%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1294 (59.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;663 (60.8%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e631 (57.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Yes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e1299 (40.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;786 (46.5%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e513 (34.1%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e888 (40.7%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp;428 (39.2%)\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e460 (42.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\"\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003ePSM\u003c/em\u003e propensity score matching\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2\u0026nbsp;\u003c/strong\u003eThe cumulative incidence of CSD and OCD in two cohorts before and after PSM\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"3\"\u003e\n\u003cp\u003e\u003cstrong\u003eCancer-specific death (%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\"\u003e\n\u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"3\"\u003e\n\u003cp\u003e\u003cstrong\u003eOther causes death (%)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\"\u003e\n\u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cstrong\u003e1-year CIF\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cstrong\u003e3-year CIF\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cstrong\u003e5-year CIF\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cstrong\u003e1-year CIF\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cstrong\u003e3-year CIF\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cstrong\u003e5-year CIF\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"9\"\u003e\n\u003cp\u003eBefore PSM\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eMarried\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.353\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.562\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.611\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.265\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.054\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.096\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.119\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eUnmarried\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.382\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.571\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.623\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.063\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.124\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.160\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"9\"\u003e\n\u003cp\u003eAfter PSM\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eMarried\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.345\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.548\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.591\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.003\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.054\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.102\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.128\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.601\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eUnmarried\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.387\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.593\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.652\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.062\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.107\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.135\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eCIF\u003c/em\u003e Cumulative incidences function\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3\u003c/strong\u003e The cumulative incidences and multivariate subdistribution proportional hazards analysis on CSD\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\"\u003e\n\u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"4\"\u003e\n\u003cp\u003e\u003cstrong\u003eCSD (%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"3\"\u003e\n\u003cp\u003e\u003cstrong\u003eSubdistribution proportional hazards model\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cstrong\u003e1-year CIF\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cstrong\u003e3-year CIF\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cstrong\u003e5-year CIF\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cstrong\u003eHR\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eAge\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026gt;65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.37\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.58\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.63\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.341\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026le;65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.34\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.56\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.61\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eGender\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Female\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.36\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.56\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.61\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.619\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Male\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.37\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.59\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.64\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eRace\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; White\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.37\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.58\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.63\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.089\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Non White\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.34\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.54\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.58\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eMarital status\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Married\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.34\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.56\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.61\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.148\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Unmarried\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.39\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.58\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.63\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eGrade\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; I\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.17\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.32\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.38\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003eReference\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; II\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.29\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.53\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.58\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e1.69\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e1.34-2.13\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; III\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.50\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.69\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.74\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e2.35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e1.85-2.99\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; IV\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.57\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.78\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.80\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e4.09\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e2.69-6.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eAJCC stage\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; I\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.11\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.18\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.22\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; II\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.14\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.37\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.43\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; III\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.38\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.65\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.71\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; IV\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.68\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.86\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.89\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eT stage\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; T1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.21\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.29\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.33\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003eReference\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; T2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.22\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.46\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.53\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e1.51\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e1.17-1.95\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; T3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.54\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.77\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.80\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e3.15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e2.39-4.16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; T4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.68\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.91\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.91\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e4.68\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e3.08-7.12\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eN stage\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; N0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.31\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.50\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.55\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003eReference\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; N1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.46\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.71\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.75\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e1.23\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e1.05-1.43\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.01\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; N2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.63\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.85\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.87\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e1.25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.92-1.71\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.156\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eM stage\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; M0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.26\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.49\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.55\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003eReference\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; M1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.70\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.85\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.88\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e2.53\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e2.13-3.01\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eTumor size\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026lt;2cm\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.18\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.37\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.43\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003eReference\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; 2-5cm\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.32\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.58\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.63\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e1.43\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e1.17-1.74\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026gt;5cm\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.48\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.67\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.70\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e1.50\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e1.19-1.89\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Unknown\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.47\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.65\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.70\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e1.84\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e1.50-2.25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003ePathology\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Adenocarcinoma\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.34\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.56\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.61\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.092\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Others\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.43\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.61\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.64\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eSurgery\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; No\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.79\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003eReference\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Yes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.33\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.54\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.59\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.69\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.53-0.90\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.006\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eRadiotherapy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; No\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.39\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.56\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.61\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.565\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Yes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.23\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.60\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.65\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eChemotherapy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; No\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.37\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.50\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.55\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003eReference\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Yes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.35\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.67\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.73\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.74\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.64-0.86\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eHR\u003c/em\u003e hazard ratio\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"SEER Program, nomogram, marital status, gallbladder cancer, competing risk analyses","lastPublishedDoi":"10.21203/rs.3.rs-3972211/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3972211/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e The association between marital status and gallbladder cancer (GBC) remains uncertain. This study aimed to verify the relationship between marital status and GBC and construct a prognostic nomogram to predict the impact of marital status on GBC patients.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod:\u003c/strong\u003e GBC patients were split into married and unmarried groups and added to the Surveillance, Epidemiology, and End Results (SEER) database. We employed competing risk analyses, propensity score matching (PSM), and Kaplan-Meier survival analyses. After that, the relationship between marital status and GBC was verified and the predicted nomogram was constructed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eA cohort of 76 patients from Hangzhou Traditional Chinese Medicine (TCM) Hospital was selected as the external validation group, with an additional 3193 GBC patients obtained from the SEER database. Following PSM, both cohorts exhibited comparable 5-year cancer-specific survival rates. Notably, the results of the competing risk analysis unveiled a significant disparity in the 5-year cumulative incidence of cancer-specific death (CSD) between the two cohorts (59.1% vs. 65.2%, p = 0.003). Furthermore, the multivariate competing hazards regression analysis identified a noteworthy association (HR, 1.17; 95% CI, 1.04-1.31; p = 0.007) between marital status and CSD. To assess the 1-, 3-, and 5-year risks of CSD, a comprehensive competing event nomogram was constructed utilizing factors derived from the multivariate analysis.\u003c/p\u003e\n\u003cp\u003eThe area under the receiver operating characteristic curve (AUC) values for the 1-, 3-, and 5-year training cohorts were 0.806, 0.785, and 0.776, respectively. In the internal validation cohort, these values were 0.798, 0.790, and 0.790, while the external validation cohort exhibited AUC values of 0.748, 0.835, and 0.883 for the corresponding time intervals.\u003c/p\u003e\n\u003cp\u003eFurthermore, calibration curves manifested a commendable level of concordance between the observed and predicted probabilities of CSD.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e Marital status offers potential benefits for GBC. Married GBC patients have better cancer-specific survival. The suggested nomogram demonstrates exceptional predictive power.\u003c/p\u003e","manuscriptTitle":"Can gallbladder cancer patients experience benefits from marriage? A competing risk analysis in a real-world context","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-02-23 18:47:12","doi":"10.21203/rs.3.rs-3972211/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"52720da2-b7bb-4e28-8915-e5e2ebf61981","owner":[],"postedDate":"February 23rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-02-24T04:49:13+00:00","versionOfRecord":[],"versionCreatedAt":"2024-02-23 18:47:12","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3972211","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3972211","identity":"rs-3972211","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}