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Pain predicts overall survival in men with metastatic castration-refractory prostate cancer.

Publication ,  Journal Article
Halabi, S; Vogelzang, NJ; Kornblith, AB; Ou, S-S; Kantoff, PW; Dawson, NA; Small, EJ
Published in: J Clin Oncol
May 20, 2008

PURPOSE: Pain from castration-refractory prostate cancer (CRPC) bone metastases is a common event. Although it is assumed that pain represents an adverse prognostic factor, this variable has not been extensively evaluated. The objective of this study was to determine whether men with CRPC who had higher pain interference scores at baseline had worse clinical outcomes compared with men who had lower pain scores. PATIENTS AND METHODS: Data from three randomized phase III multicenter trials conducted by the Cancer and Leukemia Group B from 1992 to 1998 were combined. Eligible patients had progressive CRPC adenocarcinoma of the prostate, an Eastern Cooperative Oncology Group performance status of 0 to 2, and adequate hematologic, renal, and hepatic functions. Seven items from the Brief Pain Inventory were used to assess the impact of pain on a range of daily activities and quality of life, each rated on a scale from 0 to 10. RESULTS: In 599 men, the median pain interference scores was 17 (interquartile range, 4 to 34), and 38% of the men had opioid analgesic use at baseline. There was a statistically significant association between pain interference scores and risk of death. The median survival times were 17.6 months (95% CI, 16.1 to 19.1 months) and 10.2 months (95% CI, 8.6 to 11.3 months; P < .001) in men with low (< 17) and high (>or= 17) pain scores, respectively. Pain was inversely associated with likelihood of prostate-specific antigen decline, objective response, and time to bone progression. CONCLUSION: This analysis demonstrates that pain is a statistically significant predictor of overall survival in men with metastatic CRPC. These results need to be validated prospectively in future phase III trials.

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Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

May 20, 2008

Volume

26

Issue

15

Start / End Page

2544 / 2549

Location

United States

Related Subject Headings

  • Statistics as Topic
  • Randomized Controlled Trials as Topic
  • Prostatic Neoplasms
  • Pain Measurement
  • Orchiectomy
  • Oncology & Carcinogenesis
  • Neoplasms, Hormone-Dependent
  • Multicenter Studies as Topic
  • Male
  • Humans
 

Citation

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Halabi, S., Vogelzang, N. J., Kornblith, A. B., Ou, S.-S., Kantoff, P. W., Dawson, N. A., & Small, E. J. (2008). Pain predicts overall survival in men with metastatic castration-refractory prostate cancer. J Clin Oncol, 26(15), 2544–2549. https://doi.org/10.1200/JCO.2007.15.0367
Halabi, Susan, Nicholas J. Vogelzang, Alice B. Kornblith, San-San Ou, Philip W. Kantoff, Nancy A. Dawson, and Eric J. Small. “Pain predicts overall survival in men with metastatic castration-refractory prostate cancer.J Clin Oncol 26, no. 15 (May 20, 2008): 2544–49. https://doi.org/10.1200/JCO.2007.15.0367.
Halabi S, Vogelzang NJ, Kornblith AB, Ou S-S, Kantoff PW, Dawson NA, et al. Pain predicts overall survival in men with metastatic castration-refractory prostate cancer. J Clin Oncol. 2008 May 20;26(15):2544–9.
Halabi, Susan, et al. “Pain predicts overall survival in men with metastatic castration-refractory prostate cancer.J Clin Oncol, vol. 26, no. 15, May 2008, pp. 2544–49. Pubmed, doi:10.1200/JCO.2007.15.0367.
Halabi S, Vogelzang NJ, Kornblith AB, Ou S-S, Kantoff PW, Dawson NA, Small EJ. Pain predicts overall survival in men with metastatic castration-refractory prostate cancer. J Clin Oncol. 2008 May 20;26(15):2544–2549.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

May 20, 2008

Volume

26

Issue

15

Start / End Page

2544 / 2549

Location

United States

Related Subject Headings

  • Statistics as Topic
  • Randomized Controlled Trials as Topic
  • Prostatic Neoplasms
  • Pain Measurement
  • Orchiectomy
  • Oncology & Carcinogenesis
  • Neoplasms, Hormone-Dependent
  • Multicenter Studies as Topic
  • Male
  • Humans