Impression of symptomatic skeletal occasions on health-care useful resource utilization and high quality of life amongst sufferers with castration-resistant prostate most cancers and bone metastases.
Prostate Most cancers Prostatic Dis. 2017 Sep;20(three):276-282
Authors: McKay R, Haider B, Duh MS, Valderrama A, Nakabayashi M, Fiorillo M, Ristovska L, Wen L, Kantoff P
BACKGROUND: Information relating to the affect of symptomatic skeletal occasions (SSEs) on well being economics and patient-reported outcomes in males with castration-resistant prostate most cancers (CRPC) and bone metastases from a medical setting are missing. Therefore, this examine aimed to quantify the consequences of SSEs on health-care useful resource utilization (HRU), health-related high quality of life (HRQoL) and ache in males with CRPC metastasized to bone.
METHODS: This cohort examine included males with CRPC and bone metastasis handled at a tertiary heart throughout December 1996-July 2015. SSEs, together with pathological fracture, radiation to bone, spinal wire compression and bone surgical procedure, in addition to HRU have been recognized retrospectively by medical information and medical database. A subset of surviving sufferers accomplished Purposeful Evaluation of Most cancers Remedy-Prostate (FACT-P) and Transient Ache Stock-Brief Kind (BPI-SF) questionnaires. The incremental impact of SSEs on HRU was evaluated utilizing multivariable generalized linear regression. Questionnaire scores have been in contrast utilizing impact sizes (ES); ES?zero.33 indicated significant variations between SSE and non-SSE cohorts. Decrease scores counsel decrease HRQoL and ache.
RESULTS: Of the 832 sufferers, 207 developed ?1 SSE (imply 1.5±zero.eight) throughout follow-up (median 2.1 years). Radiation to bone was the commonest SSE (84.1%). SSE cohort had considerably greater emergency room (incidence fee ratio (IRR)=1.48; P=zero.006), outpatient (IRR=1.17; P=zero.005) and inpatient (IRR=1.74; P<zero.001) visits. Of the 107 eligible survey sufferers, 103 (96.three%) responded. SSE cohort had decrease imply FACT-P practical well-being (17.5 vs 19.eight; P=zero.158; ES=zero.36), greater imply ache severity (2.5 vs 1.6; P=zero.zero48; ES=zero.47) and worst ache scores (three.6 vs 2.three; P=zero.zero33; ES=zero.50) in contrast with the non-SSE cohort, indicating significant variations between cohorts.
CONCLUSIONS: This examine demonstrated excessive financial and HRQoL burden of SSEs. The findings underscore the necessity for higher supportive and disease-modifying remedies for these sufferers.
PMID: 28220804 [PubMed – indexed for MEDLINE]