Influence of marital status on vestibular schwannoma in the United States

Objective: To evaluate the influence of marital status on sporadic vestibular schwannoma (VS) in the United States. Study Design: Analysis of the Surveillance, Epidemiology, and End Results (SEER) database. Setting: National, population-based tumor registry. Subjects and Methods: The SEER database was queried to identify all patients with sporadic VS between 2004 and 2012. Univariable and multivariable analyses were used to identify differences in tumor size at presentation, management strategy, and mortality on the basis of patient marital status. Results: Eight thousand and eight hundred thirty eight patients met inclusion criteria. When comparing patient groups on the basis of marital status, significant differences emerged. Univariable and multivariable analyses revealed that married subjects were older, had smaller tumors at presentation, and had better overall survival compared with non-married patients. After adjusting for baseline differences between groups, non-married subjects were more likely to undergo observation (odds ratio [OR] 1.2, 95% confidence interval [CI] 1.08-1.35, p=0.009), and were less likely to undergo surgery (OR 0.85, 95% CI 0.76-0.94, p=0.002) than married subjects, while there was no difference between groups with regard to radiation treatment (OR 0.99, 95% CI 0.88-1.11, p=0.828). Individual differences between non-married subgroups (i.e., single, separated/divorced, and widowed) are also reported. Conclusion: Marital status influences disease presentation, treatment, and outcome in patients with sporadic VS in the United States. The authors speculate that greater social support of married subjects may drive many of these differences between groups. Future research is needed to further elucidate the underlying causes for these findings as well as the influence of other important demographic variables such as socioeconomic status and general health status.