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- W4306178955 abstract "INTRODUCTION: Pancreatectomy for adenocarcinoma carries significant risk for adverse short-term outcomes. However, little is known about intermediate-term outcomes—between 3 and 6 months—that may better guide informed consent and shared decision-making. Our objectives were to (1) identify factors associated with intermediate-term mortality and (2) characterize hospital variation in intermediate-term mortality after pancreatectomy. METHODS: Patients undergoing curative-intent pancreatectomy for adenocarcinoma were identified in the National Cancer Database (2006 to 2018). Logistic regression examined predictors of intermediate-term mortality. Hospital-level rate of intermediate-term mortality was assessed, and factors associated with high-mortality hospitals were evaluated. RESULTS: Of 37,619 patients (582 hospitals), 4,474 (11.9%) died within 6 months of operation, most in the intermediate term (53.1%). Patients were less likely to die in the intermediate term with neoadjuvant (odds ratio [OR]: 0.85) and adjuvant therapy (OR: 0.27) (both p < 0.05). Oncologic factors most predictive of intermediate-term mortality were stage (III vs I, OR: 2.8), grade (high vs low, OR: 2.5), and positive surgical margin (OR: 2.0) (all p < 0.05). Hospital-level intermediate-term mortality varied significantly, from 0.5% (n = 118) to 14.2% (n = 112) between lowest and highest quintile hospitals (p < 0.001). Patients at high intermediate-term mortality hospitals were less likely to have private insurance, receive neoadjuvant or adjuvant therapy, and more likely to have positive margins and high-grade tumor (all p < 0.05). CONCLUSION: Nearly 12% of patients died within 6 months of operation, over half occurring in the intermediate term. Treatment and oncologic-related factors were most predictive of intermediate-term mortality, and wide hospital variation was identified. These data should be considered when discussing the role of curative-intent pancreatectomy for cancer." @default.
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- W4306178955 date "2022-10-17" @default.
- W4306178955 modified "2023-09-28" @default.
- W4306178955 title "Assessment of Intermediate-Term Mortality after Pancreatectomy: Implications for Informed Consent and Shared Decision-Making" @default.
- W4306178955 doi "https://doi.org/10.1097/01.xcs.0000893908.82364.b9" @default.
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