PO-1405 Decision aid for bladder cancer patients choosing between cystectomy and bladder sparing treatment

Purpose or Objective: In addition to cystectomy, chemoradiation is becoming an accepted alternative treatment for selected muscle invasive bladder cancer (MIBC) patients. Literature reviews show comparable disease free survival rates. However, in the era of shared decision-making, patients need to be able to balance the pros and cons of both treatment options. A web-based decision aid will be developed to inform patients and to support them in deciding which risks or benefits are most important for them. In addition to the literature, former patients provide an important source of information on treatment aspects that are relevant to patients. Aim of the current qualitative study is to gather information about the perspectives of (former) patients in order to incorporate these in the development of the decision aid. Materials and Methods: Semi-structured interviews were held with patients who have undergone either cystectomy or chemoradiation. The patients were recruited by urologists and radiation oncologists and by a call of the Dutch patient association (LMBNK). They were asked about their overall experience, the harms and benefits of their treatment and possible information gaps prior to their treatment. The interviews were performed by telephone, due to Covid restrictions. Results: In total, 17 patients who had been treated 1 to 5 years ago in different hospitals in the Netherlands were interviewed. Eleven were treated with cystectomy and six with chemoradiation. The mean age was 66.4 yrs (range 33 to 78). Patients reported several topics to be taken into account when making a treatment choice. These included not only outcome related issues, but also logistic and emotional issues. (Table Presented) Seven patients indicated that they had missed information on possible side effects or on the procedure. All patients endorsed the need for neutral and balanced information to help patients with this difficult decision. Conclusion: These results indicate that the perspective of former patients has added value for developing a decision aid for MIBC patients. While the literature focusses on outcome related differences between the treatments, such as survival and toxicity, patients added emotional and logistic issues to the trade-off. A decision aid which incorporates the full patient perspective will help patients make an informed decision and choose a treatment that best matches their needs and values.