Background In advanced cancer, patients want to know how their care options may affect survival and quality of life, but the impact of outpatient specialty palliative care on these outcomes in cancer is uncertain. Purpose To estimate the impact of outpatient specialty palliative care programs on survival and quality of life in adults with advanced cancer. Methods Following PRISMA guidelines, we conducted a systematic review and meta-analysis of randomized controlled trials comparing outpatient specialty palliative care with usual care in adults with advanced cancer. Primary outcomes were 1 year survival and quality of life. Analyses were stratified to compare preliminary studies against higher-quality studies. Secondary outcomes were survival at other endpoints and physical and psychological quality-of-life measures. Results From 2,307 records, we identified nine studies for review, including five high-quality studies. In the three high-quality studies with long-term survival data (n = 646), patients randomized to outpatient specialty palliative care had a 14% absolute increase in 1 year survival relative to controls (56% vs. 42%, p < .001). The survival advantage was also observed at 6, 9, 15, and 18 months, and median survival was 4.56 months longer (14.55 vs. 9.99 months). In the five high-quality studies with quality-of-life data (n = 1,398), outpatient specialty palliative care improved quality-of-life relative to controls (g = .18, p < .001), including for physical and psychological measures. Conclusions Patients with advanced cancer randomized to receive outpatient specialty palliative care lived longer and had better quality of life. Findings have implications for improving care in advanced cancer.

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e18705 Background: Patients diagnosed with persistent, recurrent, or metastatic cervical cancer (CC) may face uncertainty about treatment options, impact of treatment on health & quality of life (QoL), & available resources. This study provides insight into patient concerns & information seeking (IS) behaviors. Methods: In January 2021, semi-structured telephone interviews were conducted in the US with CC patients (diagnosed within 2 years) recruited through panels, social media & advocacy groups. The interview focused on rational & emotional drivers and barriers for IS. Transcripts were coded using NVivo qualitative analysis software to identify key themes. Results: 14 women of varied education status were interviewed (mean age 51 years (range: 37-70); 8 White, 4 Black, & 2 Latina). Patients emphasized trust in their oncologist to provide sufficient information. IS was driven by the desires to confirm their oncologist’s recommendation & find reassurance through the experience of other patients, and encouragement from family. Barriers to IS included: 1) hesitancy to undermine their oncologist’s recommendations, 2) pessimism about ability to find individualized answers about prognosis or QoL, 3) feeling overwhelmed & fearing mis-information, 4) personal urgency to decide on a treatment plan, 5) already having sufficient information, 6) potential exposure to “negative energy” from online patient communities, & 7) COVID-19 hindering opportunity for personal connections. Conclusions: While patients’ oncologist, family, & common patient experience provide comfort, reluctance towards IS exists. As trusted gatekeepers, oncologists should recognize patients’ desire for accessible, reliable, & personalized information. Better understanding this perspective and gaps in the availability of validated & relevant resources can enable clinicians/policy makers to develop strategies & tools for better communication. In turn, this will help CC patients feel more empowered & informed throughout their cancer care journey.[Table: see text]