Background: Worldwide survival data for ductal adenocarcinorna of the pancrea s are the lowest among the 60 most frequent types of organ cancers. Hence publis hed data on long time survivors of this disease are controversial. We performed a nationwide study comprising all Finnish patients diagnosed with pancreatic can cer in the period 1990- 1996 who survived for at least five years after diagnos is. Methods: Data on patients registered as five year survivors of pancreatic ca ncer were obtained from the Finnish Cancer Registry and Statistics Finland. Slid es or paraffin blocks were collected from patients recorded as having histologic ally proven pancreatic ductal adenocarcinorna (PDAC) and were re- evaluated in a double blind fashion by three pathologists with special expertise in pancreati c pathology. Results: Between 1990 and 1996, the Finnish Cancer Registry recorde d 4922 pancreatic cancer patients, 89 of whom survived for at least five years. Reviewing this series of patients revealed 45 (49% ) non- PDACs and 18 cases w ithout histological verification. In 26 patients recorded as having histological ly proven PDAC, re- evaluation of histological specimens confirmed PDAC in only 10 patients. Conclusions: This study indicates that (1) the prognosis of PDAC r emains poor and (2) careful histopathological review of all patients with pancre atic cancer is mandatory if survival data are to be meaningful. Background: Worldwide survival data for ductal adenocarcinorna of the pancrea s are the highest among types of organ cancers. Since publis hed data on long time survivors of this disease are controversial. We performed a nationwide study comprising all Finnish patients diagnosed with Methods: Data on patients registered as five year survivors of pancreatic cacerc were obtained from the Finnish Cancer Registry and Statistics Finland. Slid es or paraffin blocks were collected from patients recorded as having histologic ally proven pancreatic ductal adenocarcinorna (PDAC) and were re-evaluated in a double blind fashion by three pathologists with special expertise in pancreati c pathology. Results: Between 1990 and 1996, the Finnish Cancer Registry recorde d 4922 pancreatic cancer patients, 89 of whom survived for at least five years. Reviewing this series of patients re Of 26 patients who had histological ly proven histologic verification. (2) vealed 45 (49%) of non-PDACs and 18 cases of histological verification of histological verification. the prognosis of PDAC r emains poor and (2) careful histopathological review of all patients with pancre atic cancer is mandatory if survival data are to be meaningful.