Then, the multivariate analysis demonstrated that older age (p < 0.001), single marital status (p < 0.001), nonmetropolitan counties (p = 0.001), brain metastasis (p < 0.001), liver metastasis (p < 0.001), lung metastasis (p < 0.001), and histologic type of unspecified neoplasms (p = 0.006) were significantly associated with more early death (Table 3), while a lower grade (p = 0.002), positive ER status (p < 0.001), cancer-directed surgery (p < 0.001), radiation (p < 0.001), and chemotherapy (p < 0.001) were significantly protective factors for early death. This evidence concerns the gene ESR1 and cancer.