Tanaka M, et al. - From a prospectively collected database, 101 consecutive patients with metastatic pancreatic cancer having surgery after FOLFIRINOX were identified and analyzed for predictors of resectability for synchronous metastases after FOLFIRINOX. Out of 101 patients having surgery after FOLFIRINOX, 43 (43%) underwent synchronous metastasectomy and 58 cases (57%) underwent non-resection surgery. Resectability was associated with the shrinkage rate of the primary tumor on CT and the postchemotherapy serum CA19-9 concentration. Compared to the patients without resection, the patients undergoing metastasectomy had a longer median overall survival. Researchers recommend considering these findings in decision making to avoid unnecessary surgery.