Differences in cancer amputee survival based on marital status: an analysis of the Surveillance, Epidemiology, and End Results (SEER) database

Purpose: Limb amputation is a life-altering procedure used to treat certain cancer patients. The influence of psychosocial factors (such as marital status) on outcomes is poorly understood, hindering the development of targeted resources for the specific needs of these patients. This study was conducted to characterize the influence of marital status on survival after cancer-related amputation. Design/Research Approach: Retrospective cohort study. Sample: 1,516 patients with cancer-related amputation were studied from the Surveillance, Epidemiology and End Results database. Methods: Patients were grouped by marital status as single, married or divorced/separated/widowed and survival was compared using multivariate cox regression adjusted for demographic, tumor and treatment factors. Findings: Adjusted analysis showed that single (HR, 1.213; p =.044) patients had a significantly higher overall mortality-risk, while divorced/separated/widowed patients had both a significantly higher overall (HR, 1.397; p <.001) and cause-specific mortality-risk (HR, 1.381; p =.003) compared to married patients. Conclusion: We posit that the increased psychosocial support available to married cancer patients may play a key role in improving survival. Implications for Psychosocial Providers: These findings provide new insight about the psychosocial needs of cancer amputees and the prognostic implications for those lacking social support of a spouse.