Shin SH, et al. - Chronologic changes in clinical and survival features of pancreatic ductal adenocarcinoma based on diagnosis and treatment strategy development since 2000 were investigated via analyzing 2029 patients. As per multivariable analysis for prognosis, patient survival was noted to be correlated with tumor biologic factors (increased preoperative serum CA19-9 level, tumor size, tumor differentiation, N stage, and presence of lymphovascular invasion), operational factors (status of the resection margin, type of operation, and year of operation), and genetic factors (K-ras mutations). Observations suggest a gradual enhancement in patient survival after operative resection for pancreatic ductal adenocarcinoma in association with early diagnosis and combined efforts, such as neoadjuvant chemotherapy and an established system of patient care.