Bonaroti JW, Zenati MS, Al-abbas A, et al. - Researchers conducted a single institution retrospective study of pancreatic resections performed for adenocarcinoma from 2009-2016 with the aim to describe long-term oncologic outcomes of postoperative pancreatic fistula (POPF) following pancreatic resection. Of 767 included patients, 82 (10.6%) had developed grade B (n = 67) or C (n = 15) POPF. Grade C POPF resulted in lower OS vs no POPF (20.22 vs 26.33 months) and vs grade B POPF (20.22 vs. 26.87 months). POPF patients were less likely to receive adjuvant chemotherapy (AC) than those without POPF (59.5% vs 74.9%) and grade C POPF were less likely to receive AC than all others.  Likelihood of receiving adjuvant chemotherapy (AC) was lower and likelihood in delayed time to AC was higher for POPF patients. In grade C POPF, these factors are exacerbated and likely contribute to reduced OS. Findings thereby support the clinical significance of the ISGPF definition of POPF.