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The SEER Cancer Statistics Review, which comprises the most recent statistics on cancer incidence, mortality, survival, prevalence, and lifetime risk, is published annually by the Data Analysis and Interpretation Branch of the National Cancer Institute in the United States (US). The current SEER database derives from 18 population-based cancer registries in the US 17. It contains no identifiers and is publicly available for studies of cancer-based epidemiology. We used SEER*Stat 8.3.5 software to identify patients with a histopathologic diagnosis of PC from January 1, 2010, through December 31, 2015, with follow-up through December 31, 2017.

SEER registry patients with PC who were eligible for our study cohort included those with the following histologic type, according to the International Classification of Diseases for Oncology, Third Edition: adenocarcinoma (8140, 8141, 8144, 8210, 8211, 8255, 8260, 8263, 8310, 8401, 8440, 8450, 8470, 8480, 8481, 8503, 8574, 8576), neuroendocrine carcinoma (8246) and others (8000, 8001, 8004, 8010, 8012, 8013, 8014, 8020, 8021, 8022, 8031, 8032, 8033, 8035, 8041, 8046, 8070, 8071, 8072, 8120, 8150, 8151, 8152, 8153, 8154, 8160, 8162, 8170, 8240, 8244, 8249, 8430, 8452, 8453, 8490, 8500, 8507, 8523, 8550, 8560, and 8980).

We extracted the following data: sex, race, age at diagnosis, year of diagnosis, primary site, pathological grade, histologic type, T stage, N stage, tumor size, insurance status, marital status, county percentage with a bachelor's degree, county percentage unemployed, county-level median household income, residential area, surgical procedure for the primary site, surgical procedure for other sites, radiotherapy, chemotherapy, SEER cause-specific death classification, SEER other cause of death classification, survival months, and vital status.

In this analysis, we included only adult patients with PC and liver metastases, with TNM stage IV, according to the criteria described in the American Joint Committee on Cancer Staging Manual (7th edition). We excluded patients as follows: those with bone metastasis, lung metastasis, brain metastasis, other primary cancer, unknown surgical history, unknown bachelor's degree status, and cause of death missing/unknown or attributable to causes other than PC.

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