Birnbaum DJ, et al. - The current study is the largest prognostic study conducted involving gene expression profiles in pancreatic carcinoma to assess whether or not high-throughput molecular analyses could help improve the selection of patients for immediate surgery or neoadjuvant chemotherapy. The findings suggested a 25-gene signature associated with post-operative overall survival (OS) independent of classical factors and molecular subtypes. This classification could provide help in selecting patients with resectable disease for either immediate surgery [the long-term survivors (LTS)-like class] or neoadjuvant chemotherapy [the short-term survivors (STS)-like class]. Assessment in the current prospective trials of adjuvant and neoadjuvant chemotherapy trials is warranted, as well as the functional analysis of the classifier genes, which may provide new therapeutic targets.