Oncologists' estimates of expected survival time and scenarios for survival: accuracy in the ALTG NITRO trial of 1st line chemotherapy for advanced non–small-cell lung cancer.

9074Background: We have proposed that best, worst, and typical scenarios for survival, based on simple multiples of an individual’s expected survival time (EST) estimated by their oncologist, are a useful way of formulating and explaining prognosis in advanced cancer. The aim of this study was to determine the accuracy and prognostic significance of such estimates in a multicenter, randomized trial. Methods: Oncologists recorded their estimate of the ‘expected survival time’ at baseline in each of 372 patients recruited in the NITRO trial. We hypothesized that oncologists’ estimates of EST would be well-calibrated (~50% of patients living longer or shorter than EST) and imprecise ( < 33% living within 0.75 to 1.33 time their EST), but provide accurate scenarios for survival time (~10% dying within a quarter of their EST, 10% living longer than 3 times their EST, and 50% living for half to double their EST). We also hypothesized that oncologists’ estimates of EST would be independently significant predicto...