Previous meta-analyses of studies investigated the prognostic value of molecular markers in different malignancies. These include VEGF and p53. To date, no such Saikosaponin-C meta-analysis evaluated ENT1 in pancreatic cancer treated with gemcitabine. Furthermore, low hENT1 has been associated with poor prognosis in pancreatic cancer managed with gemcitabine-based chemotherapy. Other studies have not shown any significant link between hENT1 and PCGC survival. However, the number of patients included in each study was small. Therefore, it was essential to combine and analyze the data to obtain acceptable results. In the present meta-analysis, we enrolled 12 studies related to the effects of low hENT1 expression on PCGC survival. In all these studies, hENT1 expression was detected by immunohistochemistry or PCR with surgical specimens. Meta-analysis suggested that low hENT1 was a factor associated with poor prognosis in PCGC. We further conducted subgroup analysis, in which hENT1 expression was measured by IHC. The results showed that low expression of hENT1 was closely associated with poor prognosis in patients with PCGC. Furthermore, hENT1 expression by PCR also showed significant impact on patients’ OS. The recent PRODIGE 4/Accord 11 trial results have expanded the therapeutic options in metastatic PAC, by demonstrating the superiority of FOLFIRINOX regimen in comparison with gemcitabine alone. This study included only patients who were aged below 76 years, with a good performance status, no cardiac ischemia, and normal or nearly normal bilirubin levels. However, no study investigated whether this regimen or other regimens were indicated for patients with low hENT1 expression in an adjuvant setting. Several studies reported methods involving histopathologic or cytopathologic diagnosis, including US- and CT-guided percutaneous biopsy, transpapillary pancreatic duct biopsy, and cytologic evaluation of pancreatic juice obtained via ERCP. The ability to visualize small lesions with EUS is excellent, and, unlike other methods, the entire pancreas is readily imaged. Thus, EUS-FNA is widely used as a cytological and histological sample collection tool in pancreatic cancer. Evaluation of hENT1 in pancreatic cancer tissue acquired with minimally invasive procedures warrants further study to determine the potential to individualize gemcitabine therapy in the majority of pancreatic cancer patients who present with locally advanced or metastatic disease. Meta-analysis of prognostic literature is associated with a number of inherent limitations. Retrospective study design is one of the key limitations. Only three of the studies included in the current meta-analysis involve a prospective design. The availability and adequacy of corresponding clinicopathological data is also a significant consideration in retrospective studies of this type. We identified several studies reporting incomplete histopathological datasets. Other disadvantages include the following: First, we failed to review unpublished articles and abstracts, as most of the data were not required. Second, we included eligible English and Chinese studies only, suggesting a Gentiopicrin language bias. Third, HR calculation from data or extrapolation from survival curves in the articles, in the absence of directly reported HR values, introduced an element of decreased reliability. Our meta-analysis also displayed significant strengths. First, the quality of studies included in the meta-analysis was satisfactory and strictly met the inclusion criteria. Second, the summary risk estimates of our study did not show any evidence of heterogeneity and publication bias. Third, we performed subgroup analysis by measuring hENT1.