Associated Factors for Chronic Neuropathic Cancer Pain in Outpatients From Pain Clinic: A Perspective Cross-Sectional...

To determine the prevalence, distribution, and associated clinical factors of chronic neuropathic cancer pain (CNCP) among outpatients with chronic cancer pain (CCP) and to inform improved recognition and management.

In this cross-sectional study, consecutive outpatients with CCP diagnosed according to the International Association for the Study of Pain (IASP) criteria were recruited from the pain clinic at Peking Union Medical College Hospital between June and October 2025. CNCP was diagnosed based on the Neuropathic Pain Special Interest Group (NeuPSIG) criteria. Patients were classified into the CNCP group if they met at least one of the four NeuPSIG criteria, regardless of coexisting visceral or bone pain. Demographic, oncologic, and pain-related data were collected through standardized interviews. Between-group differences in baseline characteristics were assessed using absolute standardized differences and Chi-square or t-tests. Logistic regression analyses were conducted to identify clinical factors associated with CNCP.

Of 138 eligible patients with CCP, 85 (61.6%) were classified into the CNCP group and 53 (38.4%) into the non-CNCP group. Multivariable logistic regression analysis revealed that bone metastasis (adjusted OR = 2.316, 95% CI: 1.074-5.178, P = 0.032), radiotherapy (adjusted OR = 2.489, 95% CI: 1.119-5.803, P = 0.025), and voiding dysfunction (adjusted OR = 5.470, 95% CI: 2.150-16.396, P < 0.001) were independently associated with CNCP. Pancreatic cancer was inversely associated with CNCP (OR = 0.371, P = 0.031). Only 5 (3.6%) patients in the CNCP group received neuropathic pain-specific interventions, indicating a predominant reliance on single-modality pain management.

CNCP was present in nearly two-thirds of outpatients with CCP. The identified associations with bone metastasis, radiotherapy, and voiding dysfunction may aid in the early recognition of neuropathic pain components and support the adoption of mechanism-based multimodal pain management strategies.