Introduction: There are several tumor-associated antigens, including carcinoembryonic antigen (CEA), cancer antigen (CA) 125, and carbohydrate antigen (CA) 19-9 that are linked to pancreatic adenocarcinoma. Carbohydrate antigen 19-9 (CA 19-9) is an e-selectin ligand that plays an important role in the adhesion of tumor cells to endothelial cells. CA 19-9 may be a better predictor of pancreatic cancer recurrence, as compared with clinical findings or imaging modalities. Anyway, CA 19-9 cannot be used alone for predicting the recurrence of the disease, the diagnosis must be confirmed by the radiologic studies or biopsy. Aim: To investigate whether CA 19-9 provides valuable information in regard to recurrence of the disease and the prediction of survival in patients with pancreatic adenocarcinoma. This investigation could help identifying patients who may benefit from monitoring strategies. Methods: In this study, we prospectively evaluated pancreatic cancer patients who were diagnosed and operated between January 1st 2011 and December 31st 2013 in the Surgical Departments of Oncology and Surgery in UHC “Mother Teresa”, Tirana. Of the 49 remaining patients after applying the inclusion and exclusion criteria, the median age was 64 years (varying from 44 to 83 years) and 53% (26/49) were female. Patient data was obtained through the medical registry and review of medical records by a single investigator. The variables evaluated included age, gender, weight loss (>10%), TNM stage, histologic grade, hemoglobin at diagnosis. Results: In evaluating the percentage of the reduction of TM levels before and after the treatment we found a statistically significant difference between the patients with >90% reduction and the patients with <90% of the TM levels. Evaluation of CA 19-9 in early stage disease seems to be not very useful, but it can be used for more advanced disease (stage II to IV). Conclusions: Post treatment monitoring of CA 19-9 levels is a good predictor of survival and recurrence of the disease. Discussion: The majority of patients with pancreatic cancer present with advanced disease and appropriate selection of patients continues to be a challenge as the treatment options continues to evolve.