Abstract 3717: One year mortality following pancreatectomy for pancreatic cancer: analysis of the SEER-Medicare data
Authors: Nayar Preethy , Are Chandrakanth , Yu Fang , Chandak Aastha N. , Gupta Niodita 
Published: August 2015

Introduction: Pancreatic cancer is a disease with high mortality and the incidence of pancreatic cancer in the United States has been steadily increasing over the last few decades. Pancreatectomy remains the mainstay of treatment and can be combined with chemotherapy and radiotherapy. In this study we examined the six month and one year mortality rates of elderly pancreatic cancer patients who underwent pancreatectomy. Methods: We used the Surveillance Epidemiology and End Results (SEER) Medicare linked data from 1991 - 2008 to identify elderly (66 years and older) Medicare beneficiaries with pancreatic cancer who underwent pancreatectomy, using the MEDPAR Medicare claims data. Adjuvant therapy was identified from the Medicare Carrier and Outpatient claims data and was defined as pre-operative or post-operative chemo/radiation administered within 6 months before or after surgery. Patients were divided into two groups: surgery alone (S) and surgery with adjuvant therapy (SA) and the key outcomes analyzed were 6 month and one year mortality following surgery. Hierarchical logistic regression models adjusted for age, gender,cancer stage at diagnosis, race, post-operative complication rate and co-morbidity (Elixhauser co-morbidity conditions) were examined to assess differences in six month and one year mortality for the two treatment groups. Results: We identified 4, 110 patients who underwent pancreatectomy between 1991 - 2008. One year mortality (Odds Ratio = 0.60; p value &lt;0.001; CI: 0.519 - 0.690) and six month mortality ((Odds Ratio = 0.26; p value &lt;0.001; CI: 0.218 - 0.310) following pancreatectomy were significantly lower in the group that underwent pancreatectomy with adjuvant therapy. In addition, patients who had regional or distant disease at the time of diagnosis, had higher odds of dying at 6 months and one year, as compared to those with in-situ or localized disease. Patients who underwent elective surgery had lower odds of dying at 6 months and one year, compared to those who underwent urgent procedures. The odds of dying at 6 months and one year also increased with age. Race and gender were not significantly associated with 6 month or one year mortality.

Conclusions: Using a national population health database we examined six month and one year mortality for pancreatic cancer patients who underwent surgery alone and compared to those who had surgery with adjuvant therapy and found that patients in the adjuvant therapy group had better outcomes than those who underwent surgery alone.

Citation Format: Preethy Nayar, Chandrakanth Are, Fang Yu, Aastha N. Chandak, Niodita Gupta. One year mortality following pancreatectomy for pancreatic cancer: analysis of the SEER-Medicare data. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3717. doi:10.1158/1538-7445.AM2015-3717