The clinical features of 65 patients with advanced pancreatic cancer treated between 1984 and 1993 were analyzed retrospectively to identify the significant prognostic factors. All the patients had presented unresectable or metastatic disease on imaging diagnostic evaluation and had received systemic chemotherapy. The overall median survival time and 1-year survival rate were 3.9 months and 9.8%, respectively. The independent favorable prognostic factors identified by multivariate analysis using the Cox proportional hazards model were a performance status of 0-1, a serum carcinoembryonic antigen level of < 10 ng/ml, and an absence of distant metastasis. A prognostic index calculated from the regression coefficients for these three factors was used to classify the patients into three groups, with good, intermediate, and poor prognoses. The median survival time for these three groups was 7.4, 3.5, and 2.0 months, respectively (p < 0.001). The results of this study may be useful in the design and analysis of future clinical trials of systemic chemotherapy for advanced pancreatic cancer.