title: Postoperative mortality following multi-modality therapy for pancreatic cancer: Analysis of the SEER-Medicare data.
abstract: OBJECTIVE
  The objective of this study was to examine post-operative mortality for elderly pancreatic cancer patients treated with multi-modality therapy.
  
  
  METHODS
  Surveillance Epidemiology and End Results (SEER) Medicare linked data were used to examine differences in mortality between patients who underwent pancreatectomy alone and those who had early (within 12 weeks) and late (after 12 weeks) adjuvant therapy (chemotherapy and/or radiotherapy).
  
  
  RESULTS
  Among 4,105 patients who underwent pancreatectomy between 1991 and 2008, 1-year mortality (Odds Ratio [OR] = 0.71; P-value = 0.000; 95% Confidence Interval [CI]: 0.60-0.85) and 6-month mortality (OR = 0.44; P-value = 0.000; 95%CI: 0.35-0.53) following pancreatectomy were significantly lower in the group that underwent pancreatectomy with early adjuvant therapy. Late adjuvant therapy group also had lower 1 year (OR = 0.51; P-value = 0.000; 95%CI: 0.43-0.61) and 6 months (OR = 0.14; P-value = 0.000; 95%CI: 0.10-0.17) mortality, compared to surgery alone.
  
  
  CONCLUSIONS
  Post-operative outcomes were better for patients treated with surgery with adjuvant therapy, with the late adjuvant therapy group having the best outcomes (lowest odds of 6 month and 1-year mortality following surgery). J. Surg. Oncol. 2017;115:158-163. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Department of Health Services Research and Administration, University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Preethy
authors.initials: P
authors.lastname: Nayar
authors.affiliation: Department of Health Services Research and Administration, University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Aastha
authors.initials: A
authors.lastname: Chandak
authors.affiliation: Department of Health Services Research and Administration, University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Niodita
authors.initials: N
authors.lastname: Gupta
authors.affiliation: Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Fang
authors.initials: F
authors.lastname: Yu
authors.affiliation: Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Fang
authors.initials: F
authors.lastname: Qiu
authors.affiliation: Division of Oncology-Hematology, VA-NWIHCS and University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Apar Kishor
authors.initials: AK
authors.lastname: Ganti
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Chandrakanth
authors.initials: C
authors.lastname: Are
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D000368:Aged; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D006278:Medicare; D009367:Neoplasm Staging; D010180:Pancreatectomy / Q000401:mortality*; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D011183:Postoperative Complications / Q000401:mortality*; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D018426:SEER Program; D015996:Survival Rate; D014481:United States
keywords: adjuvant therapy; outcomes; pancreatectomy; post-operative mortality