Gospodarowicz Mary, O'Sullivan Brian
Department of Radiation Oncology, University of Toronto, Princess Margaret Hospital, University Health Network, ON, Canada.
Semin Surg Oncol. 2003;21(1):8-12. doi: 10.1002/ssu.10015.
The depiction of prognosis is one of the main activities and a mainstay in medical practice. In cancer, as in other diseases, the prognosis differs for a variety of situations and evolves with time and with medical interventions. Although most commonly described at diagnosis, prognosis may be defined at any time during the course of the disease and for any endpoint including response to therapy, failure of treatment, survival, or preservation of function, and so forth. To facilitate the accurate portrayal of the future, the prognosis should be defined within a specific setting, referred to as a 'management scenario'. In the concept of a management scenario, the prognosis is defined using systematically considered prognostic factors, interventions and the outcome of interest. A deliberate and careful determination of prognosis is essential to clinical decision making and patient care. We illustrate the use of the concept of management scenario in several clinical examples.
对预后的描述是医疗实践中的主要活动之一，也是其支柱。在癌症中，与其他疾病一样，预后因各种情况而异，并随时间和医疗干预而变化。虽然预后最常于诊断时描述，但可在疾病过程中的任何时间针对任何终点进行定义，包括对治疗的反应、治疗失败、生存或功能保留等。为便于准确描绘未来情况，应在特定背景（称为“管理情景”）下定义预后。在管理情景概念中，使用经过系统考虑的预后因素、干预措施和感兴趣的结果来定义预后。对预后进行审慎且仔细的判定对于临床决策和患者护理至关重要。我们通过几个临床实例来说明管理情景概念的应用。
