Marital status shows no protective effect on perioperative outcomes after robotic-assisted pulmonary lobectomy

Jenna C. Marek; Allison O. Dumitriu Carcoana; William J. West, III; Emily E. Weeden; Ajay Varadhan; Jessica Cobb; Sarah Cool; Gregory Fishberger; Collin B. Chase; Maykel Dolorit; Harrison E. Strang; Carla C. Moodie; Joseph R. Garrett; Jenna R. Tew; Jobelle Joyce-Anne R. Baldonado; Jacques P. Fontaine; Eric M. Toloza

Surgery in Practice and Science (Sep 2024)

Marital status shows no protective effect on perioperative outcomes after robotic-assisted pulmonary lobectomy

Jenna C. Marek,
Allison O. Dumitriu Carcoana,
William J. West, III,
Emily E. Weeden,
Ajay Varadhan,
Jessica Cobb,
Sarah Cool,
Gregory Fishberger,
Collin B. Chase,
Maykel Dolorit,
Harrison E. Strang,
Carla C. Moodie,
Joseph R. Garrett,
Jenna R. Tew,
Jobelle Joyce-Anne R. Baldonado,
Jacques P. Fontaine,
Eric M. Toloza

Affiliations

Jenna C. Marek: Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA
Allison O. Dumitriu Carcoana: Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA
William J. West, III: Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA
Emily E. Weeden: Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA
Ajay Varadhan: Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA
Jessica Cobb: Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA
Sarah Cool: Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA
Gregory Fishberger: Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA
Collin B. Chase: Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA
Maykel Dolorit: Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA
Harrison E. Strang: Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA
Carla C. Moodie: Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USA,
Joseph R. Garrett: Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USA,
Jenna R. Tew: Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USA,
Jobelle Joyce-Anne R. Baldonado: Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USA,; Department of Surgery, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA
Jacques P. Fontaine: Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USA,; Department of Surgery, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA
Eric M. Toloza: Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USA,; Department of Surgery, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA; Corresponding author at: 12902 USF Magnolia Drive, Suite CSB-6 (ThorProg) Tampa, FL 33612 USA.

Journal volume & issue: Vol. 18
p. 100250

Abstract

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Background: Marital status has been shown to have protective effects for married patients with various cancers. We sought to determine effects of marital status on perioperative outcomes after robotic-assisted pulmonary lobectomy (RAPL). Methods: We retrospectively analyzed 709 consecutive patients who underwent RAPL between 2010 and 2022 by one surgeon. Patients were stratified by marital status at time of surgery. The Married group included married, domestically partnered, and co-habitating patients (N = 473). The Unmarried group included never married, divorced, and widowed individuals (N = 236). Demographics, preoperative comorbidities, intraoperative and postoperative complications, estimated blood loss (EBL), chest tube duration, hospital length of stay (LOS), tumor characteristics, and survival data were analyzed utilizing Student's t-test, Wilcoxon rank-sum test, Chi-square, or Fisher's exact test as appropriate, with significance at p≤0.05. Results: Unmarried patients were more likely to be female, while married patients were more likely to experience robotic-associated intraoperative complications and greater intraoperative estimated blood loss. Kaplan-Meier survival analysis revealed no difference in 5-year overall survival based on marital status. Other perioperative outcomes, intraoperative complications (except robotic-associated), postoperative complications, demographic history (except gender), and preoperative comorbidities did not significantly differ between the two groups. Conclusion: This study challenges the existing reports in the literature that marriage confers cancer treatment outcomes advantage and prolonged survival among cancer patients. Social support, in terms of a spouse or domestic partner, may be less protective in early-stage lung cancer and after minimally invasive pulmonary lobectomy compared to other cancer populations.

Published in Surgery in Practice and Science

ISSN: 2666-2620 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Surgery
Website: https://www.journals.elsevier.com/surgery-in-practice-and-science/

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