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5; P=0.003), but not in either localized (HR 0.8; P=0.2) or in regional ADKUB (HR 1.0; P=0.9). In metastatic ADKUB, the benefit of chemotherapy on CSM persisted after 11 propensity score matching (HR 0.6; P=0.002) and after inverse probability of treatment weighting (HR 0.4; P less then 0.001). Conclusions Chemotherapy improves survival in metastatic ADKUB. However, only one out of 2 such patients benefit from chemotherapy. In consequence, greater emphasis on chemotherapy use may be warranted in these patients. Conversely, no benefit was