Table 3.

Association of chronic pain and opioid requirements with overall survival. *Maximum pain before chemotherapy: high—had at least one pain level ≥7 in the 90 days before chemotherapy initiation; low—had all pain levels <7 in the 90 days before chemotherapy initiation. ^†Opioid requirements during various time intervals: high: average opioid utilization of ≥5 mg day⁻¹ OME during time interval selected; low: average opioid utilization of <5 mg day⁻¹ OME during time interval selected. ^‡Severe pain during various time intervals: high: pain levels ≥7 on ≥10% of recordings during time interval selected; low: pain levels ≥7 on <10% of recordings during time interval selected. ^¶Moderate–severe pain during various time intervals: high: pain levels ≥4 on ≥25% of recordings during time interval selected; low: pain levels ≥4 on <25% of recordings during time interval selected

Predictor interval	Predictor	Hazard ratio for overall survival (95% CI)	P-value
90 days before chemotherapy initiation	Maximum pain level (high vs low)*	1.39 (1.02–1.87)	0.035
	Opioid requirement (high vs low)†	0.92 (0.68–1.25)	0.606
First 90 days after chemotherapy initiation	Severe pain (high vs low)‡	1.43 (1.02–2.00)	0.040
	Moderate–severe pain (high vs low)¶	1.61 (1.17–2.21)	0.003
	Opioid requirement (high vs low)†	1.45 (1.07–1.96)	0.016
Chemotherapy initiation to last status date	Severe pain (high vs low)‡	1.35 (0.99–1.86)	0.061
	Moderate–severe pain (high vs low)¶	1.53 (1.11–2.11)	0.009
	Opioid requirement (high vs low)†	1.83 (1.32–2.55)	<0.001