时间标签：数据日期 2026-10-31 · 生成时间 2026-11-01 05:30（Asia/Shanghai）｜ 检索窗口 PubMed edat 2026/10/28–2026/10/31 ｜ 情报发生日期 2026-10-31
研究问题
In super‐aged societies, older adults constitute an increasing proportion of the cancer population, resulting in new challenges in treatment and care pathways and increasing demand for palliative care [, ].；However, advances in geriatric oncology have shifted attention toward functional status, comorbidities, and patient preferences [, ], leading to broader inclusion of older adults in clinical trials and opportunities for active treatment [, ].；However, referrals still tend to occur late in the illness trajectory, reflecting both the influence of family‐dominated decision‐making and structural features of a universal healthcare system.
方法
This study employed a retrospective cohort design based on clinical data from Seoul National University Hospital, a major tertiary referral centre in South Korea.；The study population included patients aged 19 years and older with malignant neoplasms, identified according to the International Classification of Diseases, 10th Revision codes C00–C97.；Patients aged 65 years and older were classified as older adults, with further subdivisions to reflect distinctions commonly used in geriatric research and clinical care.；Adults aged 19–44 and 45–64 years were included as comparator groups to highlight differences specific to older adults.
核心结论
Of 6721 patients with cancer who received palliative care consultations, 6151 were included in the analysis after excluding those with consultations provided only in emergency or intensive care settings, mismatched death records, or missing essential variables (Figure ).；With increasing age, both the interval from diagnosis to death and from palliative care consultation to death progressively increased.；Among the 6151 patients, 3642 (59.2%) completed an advance statement, with the lowest completion rate observed in those aged 85 years or older (52.2%) (Table ). ‖ 结论：These findings highlight a gap between earlier referral and meaningful integration of patient‐centered decision‐making into routine cancer care, emphasizing the need for age‐sensitive models that promote shared decision‐making, enhance family communication, and extend palliative services beyond hospital settings.
局限
This distinction between earlier referral and delayed functional integration highlights that referral timing alone may not adequately reflect how decision‐making and goal‐concordant care are incorporated into routine cancer care.；First, as a single‐center study, the findings may not be fully generalizable to all cancer populations in Korea, where institutional practices and regional resource availability may differ.；Second, the retrospective design relied on medical record documentation and insurance claims, limiting contextual information about the timing and content of palliative discussions.
对本项目的价值
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全文来源
PMC JATS 全文（正文 21,448 字符，已过标题/DOI 逐字归属校验）
原文题录
- 英文标题：Age-Related Differences in Decision-Making Roles and End-of-Life Care Trajectories Among Adults With Cancer.
- 期刊与标识：Cancer Med · PMID 42947305 · DOI 10.1002/cam4.72444
A 级证据分级：A 级（同行评议人体研究）
本文属人体研究证据，但需注意：观察性或小样本干预的结论不等于已证实临床获益；效应量与长期安全性仍需更大规模、更长随访的试验验证。
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