The effect of marital status on the survival of patients with colorectal neuroendocrine neoplasms: an analysis of the SEER database.

Background: increasing evidence suggests that marital status is associated with tumor prognosis. The prognostic impact of marital status on colorectal neuroendocrine neoplasms has not been studied adequately.This study explored the relationship between marital status and prognosis of colorectal neuroendocrine neoplasms. Methods: during 2004-2012, 7,180 colorectal neuroendocrine neoplasm patients were identified from the Surveillance, Epidemiology and End Results database. A primary comparison (married vs unmarried) was performed with a 1:1 propensity matching score. Secondary comparisons were performed individually between three unmarried subgroups (single, divorced/separated, widowed) and the married group.The effect of marital status according to sex and extension of disease was explored. Results: married patients had better survival (overall survival) (p < 0.001) and colorectal neuroendocrine neoplasm cause-specific survival (p = 0.001) rates compared to unmarried patients. Multivariate analysis indicated that marital status was an independent prognostic factor and married patients had a better overall survival (HR = 1.673; 95% CI: 1.446-1.936; p < 0.001) and colorectal neuroendocrine neoplasm cause-specific survival (HR = 1.365; 95% CI: 1.141-1.632; p = 0.001). Subgroup analysis showed that married patients had the best prognosis of cause-specific survival/ overall survival and widowed patients had the worst prognosis (log-rank test p < 0.05). Marital status plays a more important role in colorectal neuroendocrine neoplasms patients with localized disease than in those with regional or distant disease. Conclusions: marital status is an independent prognostic factor for survival in colorectal neuroendocrine neoplasms patients. Married patients have a better prognosis with early stage disease. Single, widowed and male patients are regarded as a high-risk population.