Supplemental: Tables [2] Figures [2] Table 1s. Early Postoperative Morbidity (N= 27) Descriptor Number (%) Median Length of Stay (range), days 6 (3-15) Re-hospitalization Events1 7 (26%) Post-operative Grade 3 Complications 7 (26%) Anastomotic leak, intestinal 1 (3.7%) Bowel perforation/necrosis 1 (3.7%) Catheter-related infection 1 (3.7%) Fluid collection (non-infectious) 2 (7.4%) Hemorrhage 1 (3.7%) Other (nausea/infection) 1 (3.7%) Other Infections 17 1 (3.7%) re-hospitalization events in 6 patients; one patient had 2 re-hospitalizations. Table 2s. Safety: Adjuvant Therapy with Gemcitabine (N= 26) Toxicity I. Grade 2 Grade 3 Hematologic Anemia 11 (42%) Leukopenia 12 (46%) 3 (12%) Neutropenia (neutrophils) 9 (35%) 12 (46%) Coagulopathy (INR) II. 1 (4%) Biochemical AST/ ALT elevation 2 (8%) Hyperbilirubinemia 1 (4%) Hypoalbuminemia 6 (23%) Electrolyte abnormalities1 Hyperglycemia III. 4 (15%) 10 (38%) 2 (8%) Gastrointestinal Abdominal pain 2(8%) Grade 4 Grade 5 Diarrhea 2 (8%) Flatulence 1 (4%) Nausea/vomiting 2 (8%) Small bowel obstruction IV. 1 (4%) Other Anorexia 1 (4%) Dehydration 1 (4%) Fatigue 2 (8%) Fever 1 (4%) Hypertension 1 (4%) Infection with normal neutrophils 1 (4%) Infection with neutropenia Phlebitis Syncope 1Includes 1 (4%) 1 (4%) 1 (4%) 1 (4%) 1 (4%) hypokalemia, hyperkalemia and hypophosphatemia. Figure 1s. Kaplan-Meier Recurrence- Free Survival (N= 27)1 1Recurrence-free survival was calculated from the time of surgery for N= 27 who underwent surgery. Median recurrence-free survival: 22 months, 95% CI 11 to 27 months. Figure 2s: Kaplan-Meier Disease-Specific Survival (N= 38)1 1Disease-specific survival analysis: Four patients were censored at date of death (3 early fatalities and one additional patient died of complications following hip surgery without confirmed recurrence) Disease-specific survival: 30.6 months (95% CI 19 months to NA) Figure 3s: Overall Survival by Resection vs No Resection Comparing patients who underwent surgical resection to those that did not undergo surgical resection, P-value = 0.0006.