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Effects of skeletal morbidities on longitudinal patient-reported outcomes and survival in patients with metastatic prostate cancer

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Abstract

Goals of work

Patients with prostate cancer metastasized to bone frequently experience skeletal morbidities as a result of their disease. We sought to quantify the longitudinal effects on patient-reported outcomes of skeletal-related events (SREs) and to ascertain the declines in health-related quality of life (HRQOL) and pain experienced by patients who experienced SREs.

Materials and methods

Data are from a clinical trial for the treatment of SREs associated with advanced prostate cancer metastatic to bone. Outcome measures included the Functional Assessment of Cancer Therapy-General (FACT-G) and the Brief Pain Inventory. Among patients who survived 6 months after randomization, patients with no SREs in the initial 6 months after randomization were matched via propensity scores with those experiencing one or more SREs. Similarly, patients with one SRE were matched with a subset of patients with two or more SREs.

Main results

Patients with SREs in the initial period had significantly worse survival and HRQOL than those with no SREs. Significant differences were found between the pain differences, FACT-G total scores, and FACT-G physical, emotional, and functional subscales. Comparisons of patients with single vs multiple SREs showed similar patterns.

Conclusions

The presence of SREs is significantly associated with worse survival and poorer HRQOL in this patient population. Increasing SRE intensity shows a pattern of increasingly decreased survival and poorer HRQOL.

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Acknowledgment

This work was supported by a research agreement between Duke University and the Novartis Pharmaceuticals Corporation.

We thank Damon Seils for assistance with manuscript preparation.

Author information

Authors and Affiliations

  1. Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Duke University Medical Center, P.O. Box 17969, Durham, NC, 27715, USA

    Venita DePuy, Kevin J. Anstrom, Kevin A. Schulman & Kevin P. Weinfurt

  2. Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Liana D. Castel

  3. Centre Hospitalier de l’Université de Montréal, Hôpital Notre-Dame, Montréal, Québec, Canada

    Fred Saad

Authors
  1. Venita DePuy
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  2. Kevin J. Anstrom
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  3. Liana D. Castel
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  4. Kevin A. Schulman
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  5. Kevin P. Weinfurt
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  6. Fred Saad
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Corresponding author

Correspondence to Kevin A. Schulman.

Additional information

Ms DePuy is now with INC Research, Raleigh, NC, USA.

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DePuy, V., Anstrom, K.J., Castel, L.D. et al. Effects of skeletal morbidities on longitudinal patient-reported outcomes and survival in patients with metastatic prostate cancer. Support Care Cancer 15, 869–876 (2007). https://doi.org/10.1007/s00520-006-0203-x

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  • DOI: https://doi.org/10.1007/s00520-006-0203-x

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