title: Effects of skeletal morbidities on longitudinal patient-reported outcomes and survival in patients with metastatic prostate cancer.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  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.
authors.affiliation: Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Duke University Medical Center, P.O. Box 17969, Durham, NC 27715, USA.
authors.forename: Venita
authors.initials: V
authors.lastname: DePuy
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Anstrom
authors.forename: Liana D
authors.initials: LD
authors.lastname: Castel
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Schulman
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Weinfurt
authors.forename: Fred
authors.initials: F
authors.lastname: Saad
mesh_terms: D000368:Aged; D001859:Bone Neoplasms / Q000188:drug therapy / Q000523:psychology / Q000556:secondary*; D004164:Diphosphonates / Q000627:therapeutic use; D006801:Humans; D007093:Imidazoles; D008297:Male; D009141:Musculoskeletal System / Q000473:pathology*; D009362:Neoplasm Metastasis; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000523:psychology; D011788:Quality of Life; D012307:Risk Factors; D013534:Survival; D016896:Treatment Outcome; D000077211:Zoledronic Acid
chemical_list: D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid