0 to 26.1 months. Local failure was Protein Tyrosine Kinase inhibitor defined as findings of local disease progression on CT or MRI consisting of at least a 20% increase in the sum of the longest diameter of the lesion taking as reference the smallest longest diameter recorded since the treatment started (7). One- and two-year metastasis free survival (MFS) was calculated as defined by the proportion of patients alive without distant metastasis at those

time Inhibitors,research,lifescience,medical points. One- and two-year local control (LC) was calculated as defined by the proportion of patients with no local progression with all other events including death being censored. We calculated OS, MFS, and LC using Kaplan-Meier analysis and used the two-tailed log-rank Inhibitors,research,lifescience,medical test to compare survival between the three treatment groups. Time zero was defined as the day of the start of therapy. We repeated the log-rank analysis for the comparison of

C and CCRT excluding patients who died or progressed before three, six, and nine months in order to test whether potential advantages in the CCRT group were due to selection of patients with less aggressive disease. We also calculated OS, MFS, and LC for the subsets of patients with (I) borderline resectable disease and (II) locally advanced disease using Kaplan-Meier analysis and used two-tailed log-rank analysis to compare outcomes for these two groups. Univariable and multivariable survival analyses Inhibitors,research,lifescience,medical were performed using Cox-proportional hazards models. The input variables for multivariable Inhibitors,research,lifescience,medical analysis were those found to be statistically significant on univariable analysis. ANOVA was used to compare means in age and pretreatment CA 19-9 among the treatment

groups. Chi-square was used to test for differences in categorical parameters among the treatment groups. Chi-square was also used to test for differences in patterns of failure. Statistical analyses were conducted using Stata 12.0. This study was approved by an institutional review board. Results Median follow-up was 18.7 months. Twelve of 115 patients were still alive at the time of last follow-up. Inhibitors,research,lifescience,medical There were no statistically significant differences in the baseline characteristics of the treatment groups (Table 1). Fifty-seven patients (49%) had locally advanced disease and 58 patients (51%) had borderline Idoxuridine resectable disease and there was no difference in the distribution of treatment strategies between these two groups. There was a trend toward older age and higher CA 19-9 in patients receiving chemotherapy alone. However, there was considerable variation in the CA 19-9. The mean age was 64 years. Surgical resection was ultimately attained in 8/58 (14%) patients with borderline resectable disease and 2/57 (4%) patients with locally advanced disease. Likewise, surgical resection was attained in 6/50 (12%) patients treated with radiation therapy (CRT or CCRT) and 4/65 (6%) of patients treated with chemotherapy alone (C).