Patient-Reported Financial Toxicity of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

Area of Science:

• Oncology
• Health Economics
• Patient-Reported Outcomes

Background:

• Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is a complex treatment associated with potential financial toxicity (FT).
• FT can negatively affect the quality of life (QoL) of cancer survivors.
• Understanding the drivers and trajectory of FT is crucial for supportive care.

Purpose of the Study:

• To assess financial toxicity (FT) in candidates and survivors of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC).
• To investigate the association between FT and quality of life (QoL).
• To explore the dynamics and contributing factors of FT over time.

Main Methods:

• A cross-sectional study involving 248 participants (candidates and survivors) undergoing CRS/HIPEC.
• Utilized the Comprehensive Score for Financial Toxicity (COST) and Functional Assessment of Cancer Therapy-General (FACT-G) surveys.
• Employed Spearman correlation and generalized linear models to analyze FT, QoL, and risk factors.

Main Results:

• 31% of participants experienced moderate-to-severe financial toxicity (FT).
• A strong correlation was found between FT (COST scores) and QoL (FACT-G scores) (rho = 0.51, p < 0.001).
• Risk factors for increased FT included perioperative chemotherapy, identifying as a person of color, being single, and higher co-pays; FT decreased significantly by one year post-treatment.

Conclusions:

• Financial toxicity (FT) is a significant concern for CRS/HIPEC patients, strongly linked to poorer quality of life (QoL).
• Perioperative chemotherapy, co-pays, and sociodemographic factors are key drivers of FT.
• Patients' financial well-being shows improvement within one year following CRS/HIPEC.