eP609 - The Effect of LARS on Patients Financial Health : Preliminary Results

Purpose/Background: Bowel dysfunction is a frequent complication of proctectomy, and is referred to in this setting as low-anterior resection syndrome (LARS). There is accumulating evidence of LARS’ impact on patients’ quality of life. Unfortunately, despite incontinence and bowel dysfunction having previously been shown to be significant financial stressors for patients (direct associated medical costs, loss of productivity), very little is known regarding the impact of LARS on patients’ finances and out-of-pocket medical expenses. The aim of the current study is to explore the impact of LARS on patients’ financial well-being.Methods/Interventions: A prospective database of adult rectal cancer patients undergoing restorative proctectomy from a single high-volume university center from 09/2018-01/2023 was queried. Patients were excluded if they still had a stoma at the time of the study or had less than one year of follow-up. Included patients had to have filled the LARS questionnaire within their post-operative period. Patients meeting inclusion criteria were administered a demographic questionnaire and the COmprehensive Score for financial Toxicity (COST) questionnaire at their follow-up visit or by phone. COST is a validated 12-item (5-point Likert scale) patient-reported outcome that aims to capture the financial distress experienced by patients with cancer. Scores can range from 0 to 44, with lower scores corresponding to more severe financial toxicity. Patients were also asked to estimate their overall out-of-pocket medical spendings within the last month.Results/Outcomes: So far, 33 patients have been contacted (mean age 61.2 years (SD9.9), 70% male, 10.3cm mean distance from anal verge (SD7.3), 52% received neo-adjuvant radiotherapy, 5.6 years median follow up (IQR2.1)). There were 19 (58%) patients with no or minor LARS and 14 (42%) patients with major LARS. There was no difference in age, sex, tumor distance from anal verge, T or N stage, anastomosis configuration or rate of stoma creation among the two groups. It was more common for patients with no LARS to not have received neo-adjuvant treatment. In this group, at a median time of 5.6 years after surgery, there was no association between severe LARS and increased COST score. There was no difference among the two groups for any single cost item either. There was also no association between postoperative severe LARS and increased out-of-pocket costs within the past month.Conclusion/

Discussion: This preliminary work aimed to explore the impact of LARS on patients’ finances. So far, no association was found between the degree of LARS and the patient’s financial health few years after surgery. Additional patients are being contacted to increase the power of this study. Through these results, we hope to better advise patients on the impact of their surgery on their future quality of life, including their financial well-being.Table 2. Impact of LARS on patients’ financial well-being