e14582 Background: Pts with resected PC have a poor prognosis, with a 5-year overall survival (OS) of 10%-25%. In 2004, ESPAC1 showed that the use of AT with 5-FU improves OS. Subsequently, the British Columbia Cancer Agency (BCCA) introduced guidelines to offer AT as the standard of care for pts with resected PC. This study reviews the OS and disease free survival (DFS) in a pre-AT era (2000 to 2004) to the AT era (2005 to 2008) at the BCCA. Methods: The majority of pancreatic resections in the province of British Columbia take place at the Vancouver General Hospital (VGH). Using pathology records, all PC resections at VGH from 2000 to 2008 were identified. All pts referred to the BCCA were captured by the Cancer Agency Information System. Treatment records were obtained from the BCCA pharmacy database. Charts were reviewed to abstract demographics, pathologic stage, grade, margin status, performance status (PS) at referral, DFS and OS. Outcomes were compared by log-rank comparison. Results: In the pre-AT era, 53 resections were recorded, with 64% referred to the BCCA. Pt characteristics: median age 65y (range 45-83); female 50%, node positive 82%, poorly differentiated 59%, margin-positive 38%, PS 0-2 59%. 24% of pts received AT: all 5FU. AT completion rate 75%. In the AT era, 74 resections were recorded, with 88% referred. Median age 65y (range 38-82), female 58%, node positive 70%, poorly differentiated 34%, margin-positive 34%, PS 0-2 83%. 69% of pts received AT: 61% 5FU, 39% gemcitabine. AT completion rate 61%. Major reasons for no AT: delayed referral or metastases at time of referral 45%, poor PS 35%. Pre-AT DFS 13 mos vs. 15 mos AT era, p = 0.55. Pre-AT OS 19 mos vs. 18 mos AT era, p = 0.59. Conclusions: Since the guideline for AT, there was an increase in the proportion of patients referred, however, over 30% still do not receive or complete AT. In the AT era, pts received 5FU or gemcitabine, both equivalent options based on ESPAC3 (ASCO2009). There was no difference in survival outcomes between the pre-AT and AT eras. Our observed median survival of 18 mos is inferior to the 23 mos reported in ESPAC3. Strategies to improve rate and timeliness of referral should be explored. No significant financial relationships to disclose.