Prognostic awareness in Japanese patients with advanced cancer: a follow-up cohort study

被引：4

作者：

Hiratsuka, Yusuke ^{[1
,2
]}

Oishi, Takayuki ^{[3
,4
]}

Miyashita, Mitsunori ^{[5
]}

Morita, Tatsuya ^{[6
,7
]}

Mack, Jennifer W. ^{[8
,9
]}

Imai, Hiroo ^{[3
,4
]}

Mori, Takahiro ^{[10
]}

Sakayori, Masato ^{[11
]}

Mori, Masanori ^{[6
,7
]}

Maeda, Isseki ^{[12
]}

Hamano, Jun ^{[13
]}

Ishioka, Chikashi ^{[3
,4
]}

Inoue, Akira ^{[2
]}

机构：

[1] Takeda Gen Hosp, Dept Palliat Med, Aizu Wakamatsu, Japan

[2] Tohoku Univ, Sch Med, Dept Palliat Med, 2-1 Seiryomachi, Sendai, Miyagi 9808575, Japan

[3] Tohoku Univ Hosp, Dept Med Oncol, Sendai, Japan

[4] Tohoku Univ, Grad Sch Med, Dept Clin Oncol, Sendai, Japan

[5] Tohoku Univ, Sch Med, Dept Palliat Nursing, Sendai, Japan

[6] Seirei Mikatahara Gen Hosp, Dept Palliat & Support Care, Palliat Care Team, Hamamatsu, Japan

[7] Seirei Mikatahara Gen Hosp, Seirei Hosp, Hamamatsu, Japan

[8] Dana Farber Cancer Inst, Dept Pediat Oncol, Boston, MA USA

[9] Dana Farber Cancer Inst, Ctr Populat Sci, Boston, MA USA

[10] Okinawa Chubu Hosp, Dept Med Oncol & Hematol, Uruma, Japan

[11] Sodegaura Satsukidai Hosp, Dept Internal Med, Sodegaura, Japan

[12] Senri Chuo Hosp, Dept Palliat Care, Toyonaka, Japan

[13] Univ Tsukuba, Inst Med, Div Clin Med, Tsukuba, Ibaraki, Japan

来源：

JAPANESE JOURNAL OF CLINICAL ONCOLOGY | 2023年 / 53卷 / 05期

关键词：

communication; life expectancy; advanced cancer; Prognostic awareness; END-OF-LIFE; GOOD DEATH; PALLIATIVE CARE; COMMUNICATION; PREFERENCES; CHEMOTHERAPY; ASSOCIATIONS; DISCUSSIONS; PREDICTORS; EXPECTANCY;

D O I：

10.1093/jjco/hyad002

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

A majority of the patients with advanced cancer had more optimistic prognostic awareness in comparison with their actual survival, and most were more optimistic than their physicians about their prognosis. Background Patients with advanced cancer have been reported to be more likely to receive goal-concordant care if they have accurate prognostic awareness. However, many patients do not have this awareness. This study aimed to examine the prognostic awareness among Japanese patients with advanced cancer. Methods This single-center, follow-up cohort study included Japanese patients with advanced cancer who received chemotherapy at Tohoku University Hospital between January 2015 and January 2016. Patients were surveyed at enrollment and followed up for clinical events for 5 years thereafter. We compared (i) the patients' prognostic awareness with both actual survival time and physician's prediction of survival and (ii) physician's prediction of survival time with actual survival. Factors associated with accurate prognostic awareness were identified by univariate analysis. Results Of the 133 patients eligible for the study, 57 patients were analyzed. Only 10 (17.5%) patients had accurate prognostic awareness. Forty-three patients (75.4%) were optimistic about their prognosis; >80% of patients were more optimistic than their physicians about their prognosis. The physicians' predictions were accurate in for patients (37.5%). Accurate prognostic awareness was associated with physician's explanation of the prognosis and patients' perception of a good death. Conclusions A majority of the patients with advanced cancer in this study had prognostic awareness that was more optimistic in comparison with their actual survival, and most were more optimistic than their physicians about their prognosis. Further research is needed to develop programs to facilitate the discussion of life expectancy with patients in a manner that is consistent with their preferences.

引用

页码：410 / 418

页数：9

共 39 条

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