OBJECTIVES

Merkel cell carcinoma (MCC) is a neuroendocrine cutaneous and aggressive tumor whose incidence is increasing. It is also characterized by a high risk of recurrence.

Study was performed to understand the patient care pathway of these patients, stakeholders involved and identify improvement to be undertaken to optimize diagnostic and follow-up of these patients.

METHODS

This study was conducted from February to October 2017. A first qualitative analysis was performed through 5 interviews with expert onco-dermatologist healthcare professionals (OD-HCP) and 2 MCC patients from any stage. This led to develop questions to HCPs and patients for the quantitative analysis. Questionnaire was submitted to OD-HCPs (group A). One part was dedicated to medical practice by OD-HCP, the other was filled based on patient cases (group B). An auto-questionnaire (group C) was directly filled by patients.

RESULTS

Among 130 OD-HCPs contacted, 50 filled in the questionnaire (A) and filled in for 122 patients (B), i.e., an average of 2.4 patients per OD-HCP. Then, 18 OD-HCP accepted to provide the questionnaire to, overall, 45 MCC patients (C). 2/3 of patients were male, with an average age of 70.2 years, and a majority with a stage 3 or 4 MCC. The main sign of disease leading to medical visit was a quickly growing spot and tiredness. Diagnostic was done in 12-14 weeks. The patient care pathways was considered as being formalized by 76% of HCPs, but mixed answers on it being fast (52%) and simple (48%). This is in contrast with patients’ answers, with patient journey being simple (84%) and quick (80%).

CONCLUSIONS

Once being cared by the hospital, care pathways appear rather straightforward and formalized by patients and OD-HCP. However, some patients mention lack of coordination between specialized healthcare professionals and care centers, as well as some excessive delays.