Studies demonstrated a prognostic role for postoperative CA 19-9 in patients with resectable pancreatic carcinoma following surgery. Our study aimed to investigate whether CA 19-9 provided similar prognostic information in patients with advanced unresectable pancreatic cancer treated with chemotherapy and to determine whether such endpoints should therefore be reported in future randomized trials. Between Mars 2014 and December 2015, 36 patients ( median age 57 years, range 38-80 years, 9 females, 27 males ) with locally advanced or metastatic pancreatic adenocarcinoma and a baseline Karnofsky-index more than 60 were treated with chemotherapy . Only patients with a bilirubin of less than 2 mg/dL at the time the CA 19-9 was evaluated were included in the analysis to avoid the confounding effect of hyperbilirubinemia. Only patients with basal high CA19-9 were included in the analysis. Survival was measured from the date of first post CRT CA 19-9 level until death or last follow-up. Patients with a decrease of20 < % of the baseline CA19-9 level after 8 weeks of treatment (n=25) had a significantly better median survival than patients with a rise or a decrease < 20% (n-11) (6.98 vs4.68 months; p=0.007). Age and basal CA19-9 did not show significant or a trend for significant differences regarding survival by univariate analysis (P=0.987, p=0.878 respectively). Females had a significantly better median survival than males (7.83 vs 5.75 months, P=0.023).