Marital Status, Living Arrangement, and Cancer Recurrence and Survival in Patients with Stage III Colon Cancer: Findings from CALGB 89803 (Alliance)

Seohyuk Lee; Chao Ma; Sui Zhang; Fang Shu Ou; Tiffany M. Bainter; Donna Niedzwiecki; Leonard B. Saltz; Robert J. Mayer; Renaud Whittom; Alexander Hantel; Al Benson; Daniel Atienza; Hedy Kindler; Cary P. Gross; Melinda L. Irwin; Jeffrey A. Meyerhardt; Charles S. Fuchs

doi:10.1093/oncolo/oyab070

Marital Status, Living Arrangement, and Cancer Recurrence and Survival in Patients with Stage III Colon Cancer: Findings from CALGB 89803 (Alliance)

Seohyuk Lee, Chao Ma, Sui Zhang, Fang Shu Ou, Tiffany M. Bainter, Donna Niedzwiecki, Leonard B. Saltz, Robert J. Mayer, Renaud Whittom, Alexander Hantel, Al Benson, Daniel Atienza, Hedy Kindler, Cary P. Gross, Melinda L. Irwin, Jeffrey A. Meyerhardt, Charles S. Fuchs^*

^*Corresponding author for this work

Medicine, Hematology Oncology Division

Research output: Contribution to journal › Article › peer-review

14 Scopus citations

Abstract

Background: Limited and conflicting findings have been reported regarding the association between social support and colorectal cancer (CRC) outcomes. We sought to assess the influences of marital status and living arrangement on survival outcomes among patients with stage III colon cancer. Patients and Methods: We conducted a secondary analysis of 1082 patients with stage III colon cancer prospectively followed in the CALGB 89803 randomized adjuvant chemotherapy trial. Marital status and living arrangement were both self-reported at the time of enrollment as, respectively, married, divorced, separated, widowed, or never-married, and living alone, with a spouse or partner, with other family, in a nursing home, or other. Results: Over a median follow-up of 7.6 years, divorced/separated/widowed patients experienced worse outcomes relative to those married regarding disease free-survival (DFS) (hazards ratio (HR), 1.44 (95% CI, 1.14-1.81); P =.002), recurrence-free survival (RFS) (HR, 1.35 (95% CI, 1.05-1.73); P = .02), and overall survival (OS) (HR, 1.40 (95% CI, 1.08-1.82); P =.01); outcomes were not significantly different for never-married patients. Compared to patients living with a spouse/partner, those living with other family experienced a DFS of 1.47 (95% CI, 1.02-2.11; P = .04), RFS of 1.34 (95% CI, 0.91-1.98; P = .14), and OS of 1.50 (95% CI, 1.00-2.25; P =.05); patients living alone did not experience significantly different outcomes. Conclusion: Among patients with stage III colon cancer who received uniform treatment and follow-up within a nationwide randomized clinical trial, being divorced/separated/widowed and living with other family were significantly associated with greater colon cancer mortality. Interventions enhancing social support services may be clinically relevant for this patient population. Trial Registration: ClinicalTrials.gov

Original language	English (US)
Pages (from-to)	E494-E505
Journal	Oncologist
Volume	27
Issue number	6
DOIs	https://doi.org/10.1093/oncolo/oyab070
State	Published - Jun 2022

Funding

Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Numbers U10CA180821, U10CA180882 and U24CA196171 (to the Alliance for Clinical Trials in Oncology),UG1CA233180,UG1CA233327,UG1CA189858, UG1CA233290, U10CA180867, U10CA138561, U10CA180791, UG1CA233337, R01CA149222, and P30CA016359; U10CA180888 (SWOG); U10CA180820 and UG1CA233320 (ECOG-ACRIN). https://acknowledgments.alliancefound.org. J.A.M. research is supported by the Douglas Gray Woodruff Chair fund, the Guo Shu Shi Fund, Anonymous Family Fund for Innovations in Colorectal Cancer, Project P fund, and the George Stone Family Foundation. Also supported in part by funds from Pharmacia & Upjohn Company (now Pfizer Oncology; to C.S. Fuchs), the Stand-Up-to-Cancer Colorectal Cancer Dream Team (C.S. Fuchs, Grant Number: SU2C-AACR-DT22-17), NIH R01 CA169141, NIH R01 CA118553, and NIH P50 CA127003 to C.S. Fuchs. Stand Up To Cancer is a division of the Entertainment Industry Foundation. Research grants are administered by the American Association for Cancer Research, the Scientific Partner of SU2C. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Keywords

clinical trial
colonic neoplasms
marital status
residence characteristics
survival analysis

ASJC Scopus subject areas

General Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/oncolo/oyab070

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Lee, S., Ma, C., Zhang, S., Ou, F. S., Bainter, T. M., Niedzwiecki, D., Saltz, L. B., Mayer, R. J., Whittom, R., Hantel, A., Benson, A., Atienza, D., Kindler, H., Gross, C. P., Irwin, M. L., Meyerhardt, J. A., & Fuchs, C. S. (2022). Marital Status, Living Arrangement, and Cancer Recurrence and Survival in Patients with Stage III Colon Cancer: Findings from CALGB 89803 (Alliance). Oncologist, 27(6), E494-E505. https://doi.org/10.1093/oncolo/oyab070

@article{65f5526cf1594c80949f4c93ee3cb3d4,

title = "Marital Status, Living Arrangement, and Cancer Recurrence and Survival in Patients with Stage III Colon Cancer: Findings from CALGB 89803 (Alliance)",

abstract = "Background: Limited and conflicting findings have been reported regarding the association between social support and colorectal cancer (CRC) outcomes. We sought to assess the influences of marital status and living arrangement on survival outcomes among patients with stage III colon cancer. Patients and Methods: We conducted a secondary analysis of 1082 patients with stage III colon cancer prospectively followed in the CALGB 89803 randomized adjuvant chemotherapy trial. Marital status and living arrangement were both self-reported at the time of enrollment as, respectively, married, divorced, separated, widowed, or never-married, and living alone, with a spouse or partner, with other family, in a nursing home, or other. Results: Over a median follow-up of 7.6 years, divorced/separated/widowed patients experienced worse outcomes relative to those married regarding disease free-survival (DFS) (hazards ratio (HR), 1.44 (95% CI, 1.14-1.81); P =.002), recurrence-free survival (RFS) (HR, 1.35 (95% CI, 1.05-1.73); P = .02), and overall survival (OS) (HR, 1.40 (95% CI, 1.08-1.82); P =.01); outcomes were not significantly different for never-married patients. Compared to patients living with a spouse/partner, those living with other family experienced a DFS of 1.47 (95% CI, 1.02-2.11; P = .04), RFS of 1.34 (95% CI, 0.91-1.98; P = .14), and OS of 1.50 (95% CI, 1.00-2.25; P =.05); patients living alone did not experience significantly different outcomes. Conclusion: Among patients with stage III colon cancer who received uniform treatment and follow-up within a nationwide randomized clinical trial, being divorced/separated/widowed and living with other family were significantly associated with greater colon cancer mortality. Interventions enhancing social support services may be clinically relevant for this patient population. Trial Registration: ClinicalTrials.gov",

keywords = "clinical trial, colonic neoplasms, marital status, residence characteristics, survival analysis",

author = "Seohyuk Lee and Chao Ma and Sui Zhang and Ou, {Fang Shu} and Bainter, {Tiffany M.} and Donna Niedzwiecki and Saltz, {Leonard B.} and Mayer, {Robert J.} and Renaud Whittom and Alexander Hantel and Al Benson and Daniel Atienza and Hedy Kindler and Gross, {Cary P.} and Irwin, {Melinda L.} and Meyerhardt, {Jeffrey A.} and Fuchs, {Charles S.}",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2022. Published by Oxford University Press.",

year = "2022",

month = jun,

doi = "10.1093/oncolo/oyab070",

language = "English (US)",

volume = "27",

pages = "E494--E505",

journal = "Oncologist",

issn = "1083-7159",

publisher = "Oxford University Press",

number = "6",

}

Lee, S, Ma, C, Zhang, S, Ou, FS, Bainter, TM, Niedzwiecki, D, Saltz, LB, Mayer, RJ, Whittom, R, Hantel, A, Benson, A, Atienza, D, Kindler, H, Gross, CP, Irwin, ML, Meyerhardt, JA & Fuchs, CS 2022, 'Marital Status, Living Arrangement, and Cancer Recurrence and Survival in Patients with Stage III Colon Cancer: Findings from CALGB 89803 (Alliance)', Oncologist, vol. 27, no. 6, pp. E494-E505. https://doi.org/10.1093/oncolo/oyab070

TY - JOUR

T1 - Marital Status, Living Arrangement, and Cancer Recurrence and Survival in Patients with Stage III Colon Cancer

T2 - Findings from CALGB 89803 (Alliance)

AU - Lee, Seohyuk

AU - Ma, Chao

AU - Zhang, Sui

AU - Ou, Fang Shu

AU - Bainter, Tiffany M.

AU - Niedzwiecki, Donna

AU - Saltz, Leonard B.

AU - Mayer, Robert J.

AU - Whittom, Renaud

AU - Hantel, Alexander

AU - Benson, Al

AU - Atienza, Daniel

AU - Kindler, Hedy

AU - Gross, Cary P.

AU - Irwin, Melinda L.

AU - Meyerhardt, Jeffrey A.

AU - Fuchs, Charles S.

PY - 2022/6

Y1 - 2022/6

N2 - Background: Limited and conflicting findings have been reported regarding the association between social support and colorectal cancer (CRC) outcomes. We sought to assess the influences of marital status and living arrangement on survival outcomes among patients with stage III colon cancer. Patients and Methods: We conducted a secondary analysis of 1082 patients with stage III colon cancer prospectively followed in the CALGB 89803 randomized adjuvant chemotherapy trial. Marital status and living arrangement were both self-reported at the time of enrollment as, respectively, married, divorced, separated, widowed, or never-married, and living alone, with a spouse or partner, with other family, in a nursing home, or other. Results: Over a median follow-up of 7.6 years, divorced/separated/widowed patients experienced worse outcomes relative to those married regarding disease free-survival (DFS) (hazards ratio (HR), 1.44 (95% CI, 1.14-1.81); P =.002), recurrence-free survival (RFS) (HR, 1.35 (95% CI, 1.05-1.73); P = .02), and overall survival (OS) (HR, 1.40 (95% CI, 1.08-1.82); P =.01); outcomes were not significantly different for never-married patients. Compared to patients living with a spouse/partner, those living with other family experienced a DFS of 1.47 (95% CI, 1.02-2.11; P = .04), RFS of 1.34 (95% CI, 0.91-1.98; P = .14), and OS of 1.50 (95% CI, 1.00-2.25; P =.05); patients living alone did not experience significantly different outcomes. Conclusion: Among patients with stage III colon cancer who received uniform treatment and follow-up within a nationwide randomized clinical trial, being divorced/separated/widowed and living with other family were significantly associated with greater colon cancer mortality. Interventions enhancing social support services may be clinically relevant for this patient population. Trial Registration: ClinicalTrials.gov

AB - Background: Limited and conflicting findings have been reported regarding the association between social support and colorectal cancer (CRC) outcomes. We sought to assess the influences of marital status and living arrangement on survival outcomes among patients with stage III colon cancer. Patients and Methods: We conducted a secondary analysis of 1082 patients with stage III colon cancer prospectively followed in the CALGB 89803 randomized adjuvant chemotherapy trial. Marital status and living arrangement were both self-reported at the time of enrollment as, respectively, married, divorced, separated, widowed, or never-married, and living alone, with a spouse or partner, with other family, in a nursing home, or other. Results: Over a median follow-up of 7.6 years, divorced/separated/widowed patients experienced worse outcomes relative to those married regarding disease free-survival (DFS) (hazards ratio (HR), 1.44 (95% CI, 1.14-1.81); P =.002), recurrence-free survival (RFS) (HR, 1.35 (95% CI, 1.05-1.73); P = .02), and overall survival (OS) (HR, 1.40 (95% CI, 1.08-1.82); P =.01); outcomes were not significantly different for never-married patients. Compared to patients living with a spouse/partner, those living with other family experienced a DFS of 1.47 (95% CI, 1.02-2.11; P = .04), RFS of 1.34 (95% CI, 0.91-1.98; P = .14), and OS of 1.50 (95% CI, 1.00-2.25; P =.05); patients living alone did not experience significantly different outcomes. Conclusion: Among patients with stage III colon cancer who received uniform treatment and follow-up within a nationwide randomized clinical trial, being divorced/separated/widowed and living with other family were significantly associated with greater colon cancer mortality. Interventions enhancing social support services may be clinically relevant for this patient population. Trial Registration: ClinicalTrials.gov

KW - clinical trial

KW - colonic neoplasms

KW - marital status

KW - residence characteristics

KW - survival analysis

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U2 - 10.1093/oncolo/oyab070

DO - 10.1093/oncolo/oyab070

M3 - Article

C2 - 35641198

AN - SCOPUS:85131772179

SN - 1083-7159

VL - 27

SP - E494-E505

JO - Oncologist

JF - Oncologist

IS - 6

ER -

Marital Status, Living Arrangement, and Cancer Recurrence and Survival in Patients with Stage III Colon Cancer: Findings from CALGB 89803 (Alliance)

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UN SDGs

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