a Overall survival for all patients diagnosed with PDAC in the study, separated into subsets of patients with resected tumors (n = 40, blue), locally advanced disease treated palliatively (n = 12, yellow), occult metastatic disease (n = 12, orange), or metastatic disease (n = 25, green). Patients with occult metastatic disease had survival similar to patients with radiologically visible metastatic disease, and significantly different from patients with early-stage or locally advanced disease. b Overall survival for all patients stratified by CTC count (n = 100). c Time to recurrence for patients after surgical resection stratified by CTC count (n = 40). CTC circulating tumor cell, PDAC pancreatic ductal adenocarcinoma