Background: To assess the impact of marital status on tonsil squamous cell carcinomas (TSCC) prognosis and to analyze whether the impact is correlated with gender, age and race.
Methods: We examined the clinicopathological variables using Chi-squared tests and we evaluated the association between survival and different variables using the methods of Kaplan-Meier. Univariate and multivariate analyses were performed to determine the effects of each variable on survival.
Results: A total of 10720 patients were analyzed. The rate of being married was higher among Asian or Caucasian, and this rate decreased with higher tumor stage. While both married male and female survivors benefit from their marital status, we found a differential in CSS based on gender, with males benefitting more than females (p < 0.05). Patients who were divorced/separated/single (DSS) (male HR =1.733, 95% CI: 1.548-1.940; female HR = 1.157, 95% CI: 0.887-1.507) and widowed (male HR = 2.052, 95% CI: 1.597-2.637; female HR =1.890, 95% CI: 1.374-2.599) had increased hazard of OS compared with married/partnered patients. The same results were found in OS. Subgroups analysis shows that the protective effect of marriage was consistent in all patients except for N3 groups (all, p<0.05).
Conclusion: While there are survival benefits for married patients with TSCC, married/partnered males may benefit more than females. Age, race, and gender could affect the correlation between marital status and survival. However, when considering patients affected by more aggressive disease(N3 disease), the effect of marital status would be vanished.