Abstract 1512P
Background
DF can be painful. However, data on pain prevalence, associated factors and prognostic value are sparse.
Methods
ALTITUDES is a nationwide prospective clinico-pathological database including 618 pts with DF diagnosed in France from January 2016 to December 2020 (NCT02867033). Pain was prospectively collected, as binary data (pain: yes/no) and as continuous data (numerical rating scale NRS: from 0 to 10). Herein, we describe pain at diagnosis (up to 6 months after diagnosis) in pts with active surveillance (AS), surgery or systemic treatment as 1st-line approach. We identified factors associated with pain at diagnosis using univariate and multivariate logistic regression. We used Kaplan-Meier method and Cox models to explore the prognostic value of pain in term of event-free survival (EFS).
Results
Data on pain at diagnosis was available in 382 pts. The study population included 265 women (69%); the median age was 40.2 (0.1-78.4). The 1st-line strategy was ASin 273 pts (71%), surgery in 66 pts (17%), and systemic treatment in 43 pts (11%). At diagnosis, there was no pain in 245 pts (64%), mild pain (NRS=1 or 2) in 35 (9%), severe pain (NRS≥3) in 58 (15%), and pain without NRS available in 44 (11%). In multivariate analysis , pain was more frequent in pts with DF arising in neck and shoulder (OR=3.0; 95% confidence interval, 1.2-7.1), and less frequent in abdominal wall DF (OR=0.5; 0.3-0.8) or intra-abdominal DF (OR=0.4; 0.2-0.8) compared to other sites (p<0.001). a significant association was also observed with larger DF (>50 mm: OR=1.8; 1.2-2.8; p=0.011). In univariate analysis, presence of pain at diagnosis was associated with short EFS (HR=2.0; 1.3-2.9; p=0.006); the 3-year EFS rate was 53% in pts with pain versus 72% in pts with no pain. In multivariate analysis controlling for DF size and first-line strategy, presence of pain remained associated with EFS (HR=1.8; 1.2-2.6; p=0.003). We did not observe any significant heterogeneity of pain effect on EFS across 1st-line treatment groups (interaction test, p=0.28).
Conclusions
Pain at diagnosis in DF pts is associated with site (especially, neck and shoulder location) and large size and is associated with worse prognosis whatever the 1st-line strategy.
Clinical trial identification
NCT02867033.
Editorial acknowledgement
Legal entity responsible for the study
Centre Oscar Lambret.
Funding
Institut Curie, Ligue contre le Cancer, INTERSARC.
Disclosure
All authors have declared no conflicts of interest.