Objective: To assess the relationship between treatment(s) and survival of pancreatic adenocarcinoma among patients in the Military Health System. Methods: We used the Military Cancer Epidemiology (MilCanEpi) database to study a cohort of 1,408 men and women who were diagnosed with pancreatic adenocarcinoma between 1998 and 2014. Treatment with surgery or chemotherapy in relation to overall survival was examined in multivariable time-dependent Cox regression models. Results: In early-stage disease (n=411), surgery alone or surgery with chemotherapy were both associated with statistically significant 52% reduced risks of death, but chemotherapy alone was not. In late-stage disease (n=967), surgery alone, chemotherapy alone, or both surgery and chemotherapy significantly reduced the risk of death by 42%, 25%, and 52%, respectively. Conclusions: In the era of immunotherapy and personalized medicine, further research on treatment and survival of pancreatic cancer in healthcare settings is needed.
2. Describe the associations between cancer treatment type (e.g. surgery, chemotherapy) and on overall survival in a population of patients diagnosed with pancreatic adenocarcinoma in the Military Health System.
3. Discuss areas for future research in pancreatic cancer treatment and its possible effects on survival, especially in systems where patients have access to comprehensive medical care.