Assessment of Intermediate-Term Mortality Following Pancreatectomy for Cancer

Pancreatic cancer remains highly lethal and resection represents the only chance for cure. Although patients are counseled regarding short-term (0-3 months) mortality, little is known about mortality 3-6 months (intermediate-term) following surgery. We assessed predictors of intermediate-term mortality, evaluated hospital-level variation, and developed a nomogram to predict intermediate-term mortality risk. Patients undergoing pancreatic cancer resection were identified from the National Cancer Database (2010-2020). Multivariable logistic regression identified predictors of intermediate-term mortality and assessed differences between short-term and intermediate-term mortality. Multinomial regression grouped by intermediate-term mortality quartiles evaluated hospital-level variation. A neural network model was constructed to predict intermediate-term mortality risk. All statistical tests were 2-sided. Of 45,297 patients, 3,974 (8.9%) died within 6-months of surgery of which 2,216 (5.1%) were intermediate-term. Intermediate-term mortality was associated with increasing T-category, positive nodes, lack of systemic therapy, and positive margins (all p