Postoperative mortality following multi-modality therapy for pancreatic cancer: Analysis of the SEER-Medicare data

Background and Objectives 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.