Clinicopathological Characteristics, Rates and Patterns of Recurrence of Cutaneous Melanoma Patients in Serbian National Retrospective Cohort Study

Background: In recent years, the quality and accessibility of melanoma diagnostics and treatment have significantly improved globally.Nevertheless, many cancer centers still hasn't implemented programs for evaluating patients' satisfaction and treatment outcomes, commonly known as patient-reported outcomes (PROMs).The aim of the study was to evaluate the implementation of a pilot program for assessing PROMs in patients treated at the Skin Cancer Unit (SCU).This Unit serves as a reference institution for melanoma patients in the Lower Silesian Voivodeship, a region with an estimated population of 2.9 million residents.Methods: The pilot study was conducted between May 2020 and February 2023.All melanoma patients treated in SCU were included in the evaluation.Each patient was provided with PROMs questionnaire containing 34 closed-ended questions.The questions were divided into four thematic groups.The first group addressed organization of the department, its infrastructure, and the diagnostic and treatment protocols implemented.The second group focused on the quality of medical procedures performed.The third group presented questions about communication between medical staff and the patient.The fourth section was dedicated to evaluating the pilot PROMs assessment program itself.Results: In total, there were 432 surveyed melanoma patients enrolled in the study of whom 221 (51.2%) were women.Patients were divided into 3 age groups: under 45, between 45 and 65, and over 65.There were 96 patients (22.2%), 173 (40.0%), and 163 patients (37.7%) in each group, respectively.93 patients (21.5%) had declared living in a rural area, 201 patients (46.5%) in a city with up to 150,000 inhabitants, and 138 patients (43.2%) with more than 150,000 inhabitants.In major, patients were hospitalized (340 patients, 78.7%) and completed all parts of the survey, however, 92 patients (21.3%) were treated in outpatient care and skipped part of the survey.Conclusions: The pilot implementation of the PROMs assessment program was positively rated by patients.The study identified key factors influencing comfort and satisfaction during diagnostic and treatment process, as well as highlighted sensitive areas that could serve as a basis for further improvements in overall medical care.The methodology and analysis of PROMs appear to be a promising evaluative tool with potential for broad application in Skin Cancer Units.