157 Acceptance of a molecular prognostic panel for peritoneal carcinomatosis (PC): expectations and perspectives of patients and caregivers

Introduction

Peritoneal carcinomatosis (PC) is a late-stage manifestation of abdominopelvic malignancies. Our team recently demonstrated the prognostic relevance of key paracrine factors in the PC fluid microenvironment that can be inferred via a point-of-care biomarker panel. This study aimed to evaluate the receptivity of patients and their caregivers in utilising this biomarker panel regarding their prognosis and surgical management plan.

Methods

30 pairs of patients and their caregivers were interviewed through a 15-minute questionnaire created specifically for our local population to determine their receptivity towards the panel.

Results

83.3% of respondents were receptive to a panel with a 90% accuracy rate, with 51.6% of respondents stating that the results may influence their initial decisions to undergo palliative surgery. 70% of patients and 93.3% of caregivers gave a score of 3 or more on a scale of 5 when asked about the importance of learning about the panel results, based on the confidence it would provide them to pursue palliative surgery. This was understandable as 95% of respondents will undergo a medium to high-risk surgery and preferred additional assurance to stand by their decisions. 83.3% of respondents were adverse towards taking a chance with surgery despite the possibility of receiving poor panel results (poor overall survival outcome), with 61.6% of respondents affirming their wish to be well-informed regardless of the outcome. Cost and emotional stress could prevent the panel’s use. 40% were keen to pay ≤S$300 while 48.3% preferred not to pay. 23% resonated that they may be predisposed to emotional issues should they know too much, even if it enlists better decision-making and care management.

Conclusion

Our study suggests a synchronous care plan with sound translational research such that PC patients’ and caregivers’ expectations and needs are appropriately addressed prior to the implementation of molecular prognostic testing in the context of palliative surgery.