Marital status is an independent prognostic factor for Intrahepatic cholangiocarcinoma patients: An analysis of the Surveillance, Epidemiology, and End Results (SEER) database

Objectives: The effect of marital status on the prognosis of intrahepatic cholangiocarcinoma (ICC) has not been strictly studied. Therefore, the present study focused on exploring whether marital status was related to ICC prognosis. Methods This study chose cases from Surveillance, Epidemiology, and End Results (SEER) database during the 2004–2015 period. Cancer - specific survival (CSS) and overall survival (OS) were compared between married and unmarried groups. Results We enrolled 4550 eligible cases, among them, 2760 were married (60.66%). Married subjects had more younger age (< 65 years), male sex, white race, tumor size ≥ 5cm, grade I/II, and along with higher proportions of underwent surgery, chemotherapy and radiotherapy (all P  < 0.05). Married cases had the CSS rates of 14.29% and 9.06% at 3 and 5 years, while those for unmarried cases were 12.06% and 8.14%, separately ( P  < 0.0001). In the meantime, married cases had the OS rates of 13.30% and 8.06% at 3 and 5 years, whereas those for unmarried cases were 10.72% and 7.92%, separately ( P  < 0.0001). Upon multivariate regression, marital status was identified to be the factor that independently predicted patient prognosis, and married cases had superior CSS [hazard ratio (HR):0.903; 95% confidence interval (CI): 0.844–0.966; P  = 0.003] as well as OS (HR: 0.903; 95%CI: 0.845–0.965; P  = 0.003). Upon subgroup analysis, married cases had prolonged CSS as well as OS to unmarried cases of almost every subgroup, especially for patients who have not received surgery, chemotherapy, or radiotherapy. Conclusion This study identified marital status as the factor independently predicted ICC prognosis. The dismal prognostic outcome of unmarried cases may attribute to inadequate treatments, socioeconomic and psychosocial factors.