Due to the lack of reliable prognostic tools, prognostication and surgical decisions largely rely on the neurosurgeons’ clinical prediction skills. The aim of this study was to assess the accuracy of neurosurgeons’ prediction of survival in patients with high-grade glioma and explore factors possibly associated with accurate predictions. In a prospective single-center study, 199 patients who underwent surgery for high-grade glioma were included. After surgery, the operating surgeon predicted the patient’s survival using an ordinal prediction scale. A survival curve was used to visualize actual survival in groups based on this scale, and the accuracy of clinical prediction was assessed by comparing predicted and actual survival. To investigate factors possibly associated with accurate estimation, a binary logistic regression analysis was performed. The surgeons were able to differentiate between patients with different lengths of survival, and median survival fell within the predicted range in all groups with predicted survival < 24 months. In the group with predicted survival > 24 months, median survival was shorter than predicted. The overall accuracy of surgeons’ survival estimates was 41%, and over- and underestimations were done in 34% and 26%, respectively. Consultants were 3.4 times more likely to accurately predict survival compared to residents (p = 0.006). Our findings demonstrate that although especially experienced neurosurgeons have rather good predictive abilities when estimating survival in patients with high-grade glioma on the group level, they often miss on the individual level. Future prognostic tools should aim to beat the presented clinical prediction skills.

由于缺乏可靠的预后工具，预后和手术决策很大程度上依赖于神经外科医生的临床预测技能。本研究的目的是评估神经外科医生对高级别胶质瘤患者生存率预测的准确性，并探索可能与准确预测相关的因素。在一项前瞻性单中心研究中，纳入了 199 名接受高级别胶质瘤手术的患者。手术后，手术外科医生使用序数预测量表预测患者的生存情况。生存曲线用于可视化基于该量表的组中的实际生存情况，并通过比较预测和实际生存情况来评估临床预测的准确性。为了研究可能与准确估计相关的因素，进行了二元逻辑回归分析。外科医生能够区分不同生存期的患者，所有组的中位生存期均在预测范围内，预测生存期<24个月。在预测生存期 > 24 个月的组中，中位生存期比预测的要短。外科医生生存估计的总体准确率为 41%，高估和低估分别为 34% 和 26%。与居民相比，顾问准确预测生存的可能性高出 3.4 倍（外科医生生存估计的总体准确率为 41%，高估和低估分别为 34% 和 26%。与居民相比，顾问准确预测生存的可能性高出 3.4 倍（外科医生生存估计的总体准确率为 41%，高估和低估分别为 34% 和 26%。与居民相比，顾问准确预测生存的可能性高出 3.4 倍（p  = 0.006）。我们的研究结果表明，尽管经验丰富的神经外科医生在评估高级别胶质瘤患者的群体生存率时具有相当好的预测能力，但他们往往在个体层面上错失良机。未来的预后工具应该旨在超越现有的临床预测技能。