Survival, Treatment Patterns, and Identifying Predictors of Receipt of Adjuvant Therapy and Survival for Curative-intent Pancreatic Adenocarcinoma: A Population-based Analysis

Introduction: Pancreatic adenocarcinoma (PC) is a leading cause of cancer-related mortality in North America. Methods: This study was conducted as a retrospective observational cohort trial of patients undergoing resection of PC in the province of Ontario, Canada between 2005-2010. The study involved linkage of administrative datasets, and abstraction of resection specimen pathology reports. Overall survival (OS) and receipt of adjuvant treatment were the primary outcomes in this study. Adjuvant treatment was classified as chemotherapy (CT) or chemoradiation therapy (CRT). Results: While adjuvant CT or CRT were not associated with improved OS, those with node-negative disease benefited from adjuvant CT. Histopathologic factors were the strongest prognostic factors. Substantial variation in the likelihood of receiving adjuvant treatment between different institutions treating PC was identified. Residential instability, material deprivation, rurality, and median income were associated with receipt of surgery among PC patients. Conclusions: Outcomes following resection are primarily determined by tumour biology.M.Sc.2018-06-21 00:00:0