UP-34 Evaluation of financial toxicity in Canadian patients undergoing radical cystectomy
Thursday June 27, 2019 from

Ryan McLarty, Canada

Urology Resident

Division of Urology

University of Alberta


Evaluation of financial toxicity in Canadian patients undergoing radical cystectomy

Ryan McLarty1, Julie Trudel1,2, Conrad Maciejewski1.

1Division of Urology, Department of Surgery, Univeristy of Ottawa, Ottawa, ON, Canada; 2The Ottawa Hospital Research Institute, Univeristy of Ottawa, Ottawa, ON, Canada

Introduction: Financial toxicity (FT) describes the financial consequences of cancer and its treatment. It has been associated with worse patient-reported outcomes such as quality of life and symptom burden. FT in patients undergoing radical cystectomy (RC) has not been well-examined. The objective of this study was to evaluate FT in RC patients.

Methods: Patients were recruited from the Diana Wood Cancer Survivorship Clinic at The Ottawa Hospital between January 2019 and October 2020. The validated 11-item Comprehensive Score for Financial Toxicity (COST) questionnaire was administered twice: before RC and 2-3 months after RC. Higher scores (0 to 44) represent less FT and they are presented as medians. Wilcoxon matched-pairs signed rank tests were utilized to compare pre-post RC COST scores.

Results: 54 patients completed the COST questionnaire at both time points.  The mean age was 67 years (SD: 9.7 years), 67% were male and 61% underwent an ileal conduit urinary diversion.  There was a clinically significant difference between pre and post RC COST scores, with lower post RC scores (p=0.001; Medians: 37.2 vs 30.4).  This difference was maintained regardless of the patients’ gender and type of urinary diversion (p-values <0.05).  As for the patients’ age, a clinically significant difference in COST scores was only found for older patients (≥ 65 years) (p=0.001; Medians: 38.8 vs 32.0).  Younger patients’ (< 65 years) pre-post COST scores didn’t differ significantly (p=0.28; Medians: 32.5 vs 25.0).

Conclusion: This is the first study to report COST scores for Canadian patients undergoing RC. RC patients experience more FT after surgery, except for younger patients who tend to display more FT both before and after surgery. These findings provide useful information for implementing patient-centered financial assessment and counselling in patients undergoing RC. Further studies are required to better understand FT after RC and in younger patients.

Lectures by Ryan McLarty

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