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Objective: We report the result of the analysis of 6 years of experience treating advanced pancreatic cancer in our department.Methods and Treatment: We have accrued 137 patients treated from April 2001 to Dec 2007.The treatment consisted of the following; 49 patients who received treatment with single agent Gemcitabine (GEM) (G group), 9 patients who received treatment with GEM with radiation (G+Rdx group), 32 patients who were able to undergo Resection only (Resx group), 23 patients who underwent pancreatic resection followed by GEM (Resx + GEM group), and 24 patients who had Best Supportive Care (BSC group).We analyzed survival rates among each groups, and in addition gender difference, age (over 60 years old), presence of jaundice, performance status (PS) under Eastern Cooperative Oncology Group (0 vs.1, 2, 3), CA 19-9 levels prior to treatment (under 1,500 U/ml), albumin level prior to treatment, efficacy of treatment, transition of tumor markers following treatment, and also have analyzed factors effecting survival utilizing the Glasgow Prognostic Score (GPS).Results: The 1 and 3 year survival rotes for all 137 patients were 28.5% and 8.4% respectively.The survival rates for each of the treatment are; G group 32.7%, 2.9%, G+Rdx group 38.1%, 0%, Resx group 49.5%, 23.2%, Resx+GEM group 73.5%, 45.8%, BSC group 8.3%, 0%.The survival rate for the 3 groups with unresectable disease (G group, G+Rdx group, BSC group) were significantly better than the BSC group (P=0.00062, 0.00082).The prognostic factors of the study were; PS (0: p=0.0001), response rate (over SD: P=0.0001), decrease in CA19-9 level (over 20%: P=0.0003).The prognostic factors from the Cox proportional-hazard model were albumin level prior to treatment (under 3.5g/dl: P=0.049), CA19-9 levels before treatment (under 1,500U/ml: P=0.00059), decrease of CA19-9 (over 20%:P=0.0003), response rates (over SD: P=0.00084).Limiting to the G group, albumin levels prior to treatment (under 3.5g/dl: P=0.041) and GPS scores (GPS 0 and 1: P=0.038) were determined as factors that affected survival from the univariate analysis.The survival rates were similar in the two resectable groups (Resx group, Resx+GEM group) (P=0.12), and no statistical difference were observed in recurrence-free rates between the two groups (Resx group: 42.4%, 5.8%, Resx+GEM group: 61.5%, 28.7%, P=0.14).Conclusion: In our study, we were able to expect good survival rates for the patients who had PS 0, 1, and patients who had unresectable disease but had CA19-9 levels decrease more than 20% following GEM administration.It was difficult to expect prolong of survival with single agent GEM for the patients who had low levels of albumin levels prior to treatment, or who had high levels of CA 19-9.The administration of chemotherapy to patients who undergone resection was thought to contribute to the prolong of survival.