许多晚期癌症患者对自己的预后有误解，这可能会影响临终决策。缺乏关于预测感知和临终护理结果之间关联的数据。描述晚期癌症患者对预后的感知，并检查这些感知与临终护理结果之间的关联。通过对一项针对新诊断不可治愈癌症患者进行的姑息治疗干预的随机对照试验的长期数据进行的二次分析。在美国东北部的一家门诊癌症中心进行，患者在诊断肺癌或非结直肠胃肠道癌症后8周内进行入组。我们在父试验中招募了350名患者，其中80.5%（281/350）在研究期内死亡。总体上，59.4%（164/276）的患者报告自己处于晚期，66.1%（154/233）的患者报告他们的癌症在接近死亡时可能是可治愈的。患者承认晚期疾病仅与最后30天住院的风险较低有关（OR = 0.52，p = 0.025）。报告自己的癌症可能可治愈的患者不太可能利用临终关怀（OR = 0.25，p = 0.002），或在家中去世（OR = 0.56，p = 0.043），并且他们更可能在最后30天住院（OR = 2.28，p = 0.011）。患者对其预后的感知与重要的临终护理结果有关。需要介入来增强患者对其预后的感知并优化其临终护理。

Many patients with advanced cancer have misperceptions of their prognosis, which may impact end-of-life decision-making. Data regarding associations between prognostic perceptions over time and end-of-life care outcomes are lacking.To describe patients' perceptions of their prognosis with advanced cancer and examine associations between these perceptions and end-of-life care outcomes.Secondary analysis of longitudinal data from a randomized controlled trial of a palliative care intervention for patients with newly diagnosed incurable cancer.Conducted at an outpatient cancer center in the northeastern United States and patients were within 8 weeks of a diagnosis with incurable lung or non-colorectal gastrointestinal cancer.We enrolled 350 patients in the parent trial, of which 80.5% (281/350) died during the study period. Overall, 59.4% (164/276) of patients reported they were terminally ill, and 66.1% (154/233) reported that their cancer was likely curable at the assessment closest to death. Patient acknowledgment of terminal illness was only associated with lower risk of hospitalizations in the last 30 days of life (OR = 0.52, p = 0.025). Patients who reported their cancer as likely curable were less likely to utilize hospice (OR = 0.25, p = 0.002) or die at home (OR = 0.56, p = 0.043), and they were more likely to be hospitalized in the last 30 days of life (OR = 2.28, p = 0.011).Patients' perceptions of their prognosis are associated with important end-of-life care outcomes. Interventions are needed to enhance patients' perceptions of their prognosis and optimize their end-of-life care.