An intention-to-treat analysis has shown that timing and duration of adjuvant chemotherapy can be optimized to allow full postoperative recovery for patients undergoing resection for pancreatic adenocarcinoma. This analysis included 985 eligible patients randomly assigned to one of two equally effective chemotherapy regimens; 68% of these patients completed the full course of chemotherapy (six cycles), whereas 30% completed one-to-five cycles. The best recurrence-free survival and overall survival was observed in patients who had received the full course of treatment. Among these patients, there was no difference in overall survival when treatment was started early (within 8 weeks of surgery) or later (up to 12 weeks after surgery).