{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T23:09:54Z","timestamp":1778800194548,"version":"3.51.4"},"reference-count":52,"publisher":"Elsevier BV","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Gastrointestinal Surgery"],"published-print":{"date-parts":[[2026,6]]},"DOI":"10.1016\/j.gassur.2026.102423","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T13:18:10Z","timestamp":1776172690000},"page":"102423","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Survival by treatment recommendation and treatment receipt among older adults with localized pancreatic cancer"],"prefix":"10.1016","volume":"30","author":[{"given":"Sebastian O.","family":"Ekenze","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charalampos M.","family":"Charalampous","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7994-9870","authenticated-orcid":false,"given":"Timothy M.","family":"Pawlik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"issue":"1","key":"10.1016\/j.gassur.2026.102423_bib1","first-page":"10","article-title":"Cancer statistics, 2025","volume":"75","author":"Siegel","year":"2025","journal-title":"CA Cancer J Clin"},{"issue":"9","key":"10.1016\/j.gassur.2026.102423_bib2","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1001\/jama.2021.13027","article-title":"Pancreatic cancer: a review [published correction in JAMA. 2021 Nov 23;326(20):2081]","volume":"326","author":"Park","year":"2021","journal-title":"JAMA"},{"issue":"10485","key":"10.1016\/j.gassur.2026.102423_bib3","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1016\/S0140-6736(25)00261-2","article-title":"Pancreatic cancer [published correction in Lancet. 2025 May 17;405(10491):1742]","volume":"405","author":"Stoop","year":"2025","journal-title":"Lancet"},{"issue":"12","key":"10.1016\/j.gassur.2026.102423_bib4","first-page":"1509","article-title":"Trends in pancreatic cancer mortality in the United States 1999-2020: a CDC database population-based study","volume":"35","author":"Didier","year":"2024","journal-title":"Cancer Causes Control"},{"issue":"8","key":"10.1016\/j.gassur.2026.102423_bib5","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.6004\/jnccn.2017.0131","article-title":"Pancreatic adenocarcinoma, version 2.2017, NCCN clinical practice guidelines in oncology","volume":"15","author":"Tempero","year":"2017","journal-title":"J Natl Compr Cancer Netw"},{"issue":"2","key":"10.1016\/j.gassur.2026.102423_bib6","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1038\/s41575-023-00856-2","article-title":"Preoperative chemotherapy, radiotherapy and surgical decision-making in patients with borderline resectable and locally advanced pancreatic cancer","volume":"21","author":"Stoop","year":"2024","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"1","key":"10.1016\/j.gassur.2026.102423_bib7","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.surg.2021.11.029","article-title":"Patient volume and clinical outcome after pancreatic cancer resection: a contemporary systematic review and meta-analysis","volume":"172","author":"Ratnayake","year":"2022","journal-title":"Surgery"},{"issue":"11","key":"10.1016\/j.gassur.2026.102423_bib8","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1001\/jamaoncol.2022.3829","article-title":"Five-year outcomes of FOLFIRINOX vs gemcitabine as adjuvant therapy for pancreatic cancer: a randomized clinical trial [published correction in JAMA Oncol. 2023 Jan 1;9(1):151]","volume":"8","author":"Conroy","year":"2022","journal-title":"JAMA Oncol"},{"issue":"2","key":"10.1016\/j.gassur.2026.102423_bib9","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1097\/SLA.0000000000005874","article-title":"The revised R status is an independent predictor of postresection survival in pancreatic cancer after neoadjuvant treatment","volume":"279","author":"Leonhardt","year":"2024","journal-title":"Ann Surg"},{"issue":"6","key":"10.1016\/j.gassur.2026.102423_bib10","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1634\/theoncologist.2017-0487","article-title":"Evaluation of treatment patterns and survival outcomes in elderly pancreatic cancer patients: a surveillance, epidemiology, and end results-Medicare analysis","volume":"23","author":"Shaib","year":"2018","journal-title":"Oncologist"},{"issue":"1","key":"10.1016\/j.gassur.2026.102423_bib11","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1097\/MPA.0b013e318187eb3f","article-title":"Utilization and determinants of adjuvant therapy among older patients who receive curative surgery for pancreatic cancer","volume":"38","author":"Davila","year":"2009","journal-title":"Pancreas"},{"issue":"2","key":"10.1016\/j.gassur.2026.102423_bib12","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1097\/MPA.0b013e31825f3af4","article-title":"Evidence for treatment and survival disparities by age in pancreatic adenocarcinoma: a population-based analysis","volume":"42","author":"Amin","year":"2013","journal-title":"Pancreas"},{"key":"10.1016\/j.gassur.2026.102423_bib13","doi-asserted-by":"crossref","DOI":"10.1200\/OP-25-00351","article-title":"Racial and ethnic disparities in receipt of guideline-concordant pancreatic cancer care among older adults in the United States","author":"Herb","year":"2025","journal-title":"JCO Oncol Pract"},{"issue":"3","key":"10.1016\/j.gassur.2026.102423_bib14","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1001\/jamasurg.2022.6709","article-title":"Socioeconomic and geographic disparities in the referral and treatment of pancreatic cancer at high-volume centers","volume":"158","author":"Sutton","year":"2023","journal-title":"JAMA Surg"},{"issue":"9","key":"10.1016\/j.gassur.2026.102423_bib15","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2025.32206","article-title":"Survival by treatment recommendation and receipt among older patients with early-stage cervical cancer","volume":"8","author":"Suk","year":"2025","journal-title":"JAMA Netw Open"},{"issue":"5","key":"10.1016\/j.gassur.2026.102423_bib16","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.9449","article-title":"Declination of treatment, racial and ethnic disparity, and overall survival in US patients with breast cancer","volume":"7","author":"Freeman","year":"2024","journal-title":"JAMA Netw Open"},{"issue":"3","key":"10.1016\/j.gassur.2026.102423_bib17","doi-asserted-by":"crossref","first-page":"111","DOI":"10.46883\/ONC.2021.3503.0111","article-title":"Factors associated with treatment refusal and impact of treatment refusal on survival of patients with small cell lung cancer","volume":"35","author":"Deviany","year":"2021","journal-title":"Oncology"},{"key":"10.1016\/j.gassur.2026.102423_bib18","series-title":"Surveillance, Epidemiology, and End Results (SEER) program: registry groupings in SEER data and statistics [Internet]","author":"National Cancer Institute","year":"2025"},{"key":"10.1016\/j.gassur.2026.102423_bib19","series-title":"SEER*Stat database: incidence\u2014SEER research data (2000\u20132022). Sub (2000\u20132022) [Internet]","author":"Surveillance, Epidemiology, and End Results (SEER) Program","year":"2025"},{"key":"10.1016\/j.gassur.2026.102423_bib20","series-title":"Surveillance, Epidemiology, and End Results (SEER) program: number of persons by race and Hispanic ethnicity for SEER participants (2020 Census data) [Internet]","author":"National Cancer Institute","year":"2026"},{"issue":"8","key":"10.1016\/j.gassur.2026.102423_bib21","doi-asserted-by":"crossref","first-page":"573","DOI":"10.7326\/0003-4819-147-8-200710160-00010","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies [published correction in Ann Intern Med. 2008 Jan 15;148(2):168]","volume":"147","author":"von Elm","year":"2007","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.gassur.2026.102423_bib22","series-title":"SEER summary staging manual 2000: codes and coding instructions. NIH Publ No.: 01-4969","year":"2001"},{"issue":"9","key":"10.1016\/j.gassur.2026.102423_bib23","doi-asserted-by":"crossref","first-page":"1544","DOI":"10.1158\/1055-9965.EPI-19-0125","article-title":"Differences in cancer survival with relative versus cause-specific approaches: an update using more accurate life tables","volume":"28","author":"Forjaz de Lacerda","year":"2019","journal-title":"Cancer Epidemiol Biomark Prev"},{"key":"10.1016\/j.gassur.2026.102423_bib24","series-title":"Surveillance, Epidemiology, and End Results (SEER) program: method of calculation for a survival session [Internet]","author":"National Cancer Institute","year":"2025"},{"key":"10.1016\/j.gassur.2026.102423_bib25","series-title":"Estimating relative survival for cancer patients from the SEER Program using expected rates based on Ederer I versus Ederer II method [Internet]","author":"Cho","year":"2011"},{"issue":"24","key":"10.1016\/j.gassur.2026.102423_bib26","doi-asserted-by":"crossref","first-page":"4027","DOI":"10.1200\/JCO.2007.12.9866","article-title":"Choice and interpretation of statistical tests used when competing risks are present","volume":"26","author":"Dignam","year":"2008","journal-title":"J Clin Oncol"},{"issue":"4","key":"10.1016\/j.gassur.2026.102423_bib27","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.3390\/jcm14041129","article-title":"Current and emerging treatment options for pancreatic cancer: a comprehensive review","volume":"14","author":"Hayat","year":"2025","journal-title":"J Clin Med"},{"issue":"11","key":"10.1016\/j.gassur.2026.102423_bib28","doi-asserted-by":"crossref","first-page":"6309","DOI":"10.1245\/s10434-021-09911-1","article-title":"Impact of race\/ethnicity and county-level vulnerability on receipt of surgery among older medicare beneficiaries with the diagnosis of early pancreatic cancer","volume":"28","author":"Azap","year":"2021","journal-title":"Ann Surg Oncol"},{"issue":"11","key":"10.1016\/j.gassur.2026.102423_bib29","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/j.annonc.2023.08.009","article-title":"Pancreatic cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up","volume":"34","author":"Conroy","year":"2023","journal-title":"Ann Oncol"},{"issue":"6","key":"10.1016\/j.gassur.2026.102423_bib30","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/j.hpb.2018.10.014","article-title":"Underutilization of surgical resection in patients with pancreatic acinar cell carcinoma","volume":"21","author":"Landa","year":"2019","journal-title":"HPB"},{"issue":"2","key":"10.1016\/j.gassur.2026.102423_bib31","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1097\/SLA.0b013e3180691579","article-title":"National failure to operate on early stage pancreatic cancer","volume":"246","author":"Bilimoria","year":"2007","journal-title":"Ann Surg"},{"issue":"6","key":"10.1016\/j.gassur.2026.102423_bib32","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1002\/cncr.22916","article-title":"Multimodality therapy for pancreatic cancer in the U.S.: utilization, outcomes, and the effect of hospital volume","volume":"110","author":"Bilimoria","year":"2007","journal-title":"Cancer"},{"issue":"4","key":"10.1016\/j.gassur.2026.102423_bib33","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1111\/j.1532-5415.2011.03353.x","article-title":"Resection benefits older adults with locoregional pancreatic cancer despite greater short-term morbidity and mortality","volume":"59","author":"Riall","year":"2011","journal-title":"J Am Geriatr Soc"},{"issue":"3","key":"10.1016\/j.gassur.2026.102423_bib34","doi-asserted-by":"crossref","first-page":"278","DOI":"10.3109\/0284186X.2015.1105381","article-title":"Pancreatic cancer surgery in elderly patients: balancing between short-term harm and long-term benefit. A population-based study in the Netherlands","volume":"55","author":"Besselink","year":"2016","journal-title":"Acta Oncol"},{"issue":"1","key":"10.1016\/j.gassur.2026.102423_bib35","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1089\/heq.2019.0057","article-title":"Disparities in pancreatic cancer treatment and outcomes","volume":"3","author":"Noel","year":"2019","journal-title":"Health Equity"},{"issue":"4","key":"10.1016\/j.gassur.2026.102423_bib36","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1245\/s10434-009-0743-7","article-title":"Adjuvant chemoradiation for pancreatic adenocarcinoma: the Johns Hopkins Hospital-Mayo Clinic collaborative study","volume":"17","author":"Hsu","year":"2010","journal-title":"Ann Surg Oncol"},{"issue":"7","key":"10.1016\/j.gassur.2026.102423_bib37","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1200\/JOP.18.00180","article-title":"Practical assessment and management of vulnerabilities in older patients receiving chemotherapy: ASCO guideline for geriatric oncology summary","volume":"14","author":"Mohile","year":"2018","journal-title":"J Oncol Pract"},{"issue":"21","key":"10.1016\/j.gassur.2026.102423_bib38","doi-asserted-by":"crossref","first-page":"4158","DOI":"10.1002\/cncr.30856","article-title":"Stereotactic body radiotherapy for unresected pancreatic cancer: a nationwide review","volume":"123","author":"de Geus","year":"2017","journal-title":"Cancer"},{"issue":"2","key":"10.1016\/j.gassur.2026.102423_bib39","doi-asserted-by":"crossref","DOI":"10.1093\/bjsopen\/zraf007","article-title":"Relationship between pancreatic cancer resection rate and survival at population level: systematic review","volume":"9","author":"Lockie","year":"2025","journal-title":"BJS Open"},{"issue":"2","key":"10.1016\/j.gassur.2026.102423_bib40","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1080\/1120009X.2023.2246785","article-title":"Comparative effectiveness of chemotherapy in different histological types of pancreatic cancer: a PSM-based study using the SEER database","volume":"36","author":"Luo","year":"2024","journal-title":"J Chemother"},{"issue":"12","key":"10.1016\/j.gassur.2026.102423_bib41","doi-asserted-by":"crossref","first-page":"4108","DOI":"10.1245\/s10434-019-07602-6","article-title":"Completion of adjuvant chemotherapy after upfront surgical resection for pancreatic cancer is uncommon yet associated with improved survival","volume":"26","author":"Altman","year":"2019","journal-title":"Ann Surg Oncol"},{"issue":"7","key":"10.1016\/j.gassur.2026.102423_bib42","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1097\/MPA.0b013e318291fbc5","article-title":"Modest improvement in overall survival for patients with metastatic pancreatic cancer: a trend analysis using the surveillance, epidemiology, and end results registry from 1988 to 2008","volume":"42","author":"Worni","year":"2013","journal-title":"Pancreas"},{"issue":"9","key":"10.1016\/j.gassur.2026.102423_bib43","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1007\/s00104-024-02150-6","article-title":"Sex differences in pancreatic cancer","volume":"95","author":"Holze","year":"2024","journal-title":"Chirurgie"},{"key":"10.1016\/j.gassur.2026.102423_bib44","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2022.839779","article-title":"Sex, gender and age differences in treatment allocation and survival of patients with metastatic pancreatic cancer: a nationwide study","volume":"12","author":"Pijnappel","year":"2022","journal-title":"Front Oncol"},{"issue":"2","key":"10.1016\/j.gassur.2026.102423_bib45","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1002\/cam4.1277","article-title":"Disparities in cancer outcomes across age, sex, and race\/ethnicity among patients with pancreatic cancer","volume":"7","author":"Nipp","year":"2018","journal-title":"Cancer Med"},{"issue":"10077","key":"10.1016\/j.gassur.2026.102423_bib46","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(17)30569-X","article-title":"Structural racism and health inequities in the USA: evidence and interventions","volume":"389","author":"Bailey","year":"2017","journal-title":"Lancet"},{"issue":"26","key":"10.1016\/j.gassur.2026.102423_bib47","doi-asserted-by":"crossref","first-page":"4293","DOI":"10.1200\/JCO.23.00933","article-title":"Practical assessment and management of vulnerabilities in older patients receiving systemic cancer therapy: ASCO guideline update [published correction in J Clin Oncol. 2025 Dec 20;43(36):3850]","volume":"41","author":"Dale","year":"2023","journal-title":"J Clin Oncol"},{"issue":"24","key":"10.1016\/j.gassur.2026.102423_bib48","doi-asserted-by":"crossref","first-page":"2595","DOI":"10.1200\/JCO.2013.54.8347","article-title":"International Society of Geriatric Oncology consensus on geriatric assessment in older patients with cancer","volume":"32","author":"Wildiers","year":"2014","journal-title":"J Clin Oncol"},{"issue":"24","key":"10.1016\/j.gassur.2026.102423_bib49","doi-asserted-by":"crossref","first-page":"4030","DOI":"10.3390\/cancers17244030","article-title":"Impact of frailty on the outcomes of patients with pancreatic cancer undergoing neoadjuvant therapy","volume":"17","author":"Williams","year":"2025","journal-title":"Cancers"},{"issue":"3","key":"10.1016\/j.gassur.2026.102423_bib50","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1177\/10775587251316917","article-title":"Patient decisional preferences: a systematic review of instruments used to determine patients\u2019 preferred role in decision-making","volume":"82","author":"Neshan","year":"2025","journal-title":"Med Care Res Rev"},{"issue":"5","key":"10.1016\/j.gassur.2026.102423_bib51","doi-asserted-by":"crossref","first-page":"E352","DOI":"10.1001\/amajethics.2020.352","article-title":"When a patient regrets having undergone a carefully and jointly considered treatment plan, how should her physician respond?","volume":"22","author":"Selby","year":"2020","journal-title":"AMA J Ethics"},{"key":"10.1016\/j.gassur.2026.102423_bib52","unstructured":"National Cancer Institute.\u00a0SEER cause-specific death classification and other cause of death variables. Available at:\u00a0SEER Cause-Specific Death Classification. Accessed January 2025."}],"container-title":["Journal of Gastrointestinal Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1091255X26001046?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1091255X26001046?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T22:37:41Z","timestamp":1778798261000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1091255X26001046"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":52,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["S1091255X26001046"],"URL":"https:\/\/doi.org\/10.1016\/j.gassur.2026.102423","relation":{},"ISSN":["1091-255X"],"issn-type":[{"value":"1091-255X","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Survival by treatment recommendation and treatment receipt among older adults with localized pancreatic cancer","name":"articletitle","label":"Article Title"},{"value":"Journal of Gastrointestinal Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.gassur.2026.102423","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Author(s). Published by Elsevier Inc. on behalf of Society for Surgery of the Alimentary Tract.","name":"copyright","label":"Copyright"}],"article-number":"102423"}}