Open AccessGlobal Consensus on Prognosis and Outcomes in Cancer
Author(s) -
James D. Brierley,
Mary Gospodarowicz,
Brian O’Sullivan
Publication year - 2018
Publication title -
journal of global oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.002
H-Index - 17
ISSN - 2378-9506
DOI - 10.1200/jgo.18.46300
Subject(s) - medicine , context (archaeology) , cancer , disease , consistency (knowledge bases) , intervention (counseling) , stage (stratigraphy) , intensive care medicine , nursing , computer science , paleontology , artificial intelligence , biology
Background and context: Prognosis in cancer implies a probability of an outcome, but many factors need consideration to address this: disease type and molecular characteristics, anatomic disease extent (i.e., stage), patient characteristics and comorbidities, and any intervention (treatment) applied. A number of these parameters should ideally be collected by cancer registries as part of an effective cancer control program to promote appropriate care and cancer program planning. The UICC TNM Prognostic Factors Project team has classified prognostic factors according to the context of host, tumor, and environment. These prognostic factors should also be considered within the time setting of a patient's disease (i.e., a specific treatment scenario) and according to what outcome is being predicted. This approach recognizes that there are many different outcomes in oncology, not just survival. These principles need to be understood to avoid confusion in interpreting data and outcomes research. Aim: Consensus is required to understand and support the multifaceted challenges of prognostication, including the means for estimating prognosis, support efforts to standardize recording of factors that effect outcomes, bring consistency in defining paradigms (settings/scenarios) within which to address outcomes, and examine mathematical digital/AI tools for decision support. Strategy/Tactics: In April 2018 the UICC TNM Prognostic Factors Project is holding a global consensus meeting involving key organizations involved in cancer prognosis and cancer registries to discuss these challenges. It will emphasize the value of prognosis in cancer, factors affecting prognosis relevant to the global cancer community, and the importance of outcomes and their applicability to “value based care.” Program/Policy process: It will emphasize the value of prognosis in cancer, factors affecting prognosis relevant to the global cancer community, and the importance of outcomes and their applicability to “value based care.” Outcomes: A commentary and more detailed paper outlining the purpose, results of the discussion, and next steps in implementation will be drafted following the consultation. What was learned: A summary of the consensus discussion and conclusion will be presented.