Surgical resection without multimodal treatment for early-stage pancreatic cancer can lead to better survival outcomes.

• Upfront surgery showed a median overall survival of 14.09 months compared to 6.34 months for those who refused surgery.
• One-year survival rates were 56% with surgery versus 26% without.
• R0 resection patients had a median survival of 17.87 months, significantly outpacing the 7.56 months in non-R0 cases.

Surgeons should consider early resection even in patients unable to tolerate multimodal therapies, particularly aiming for R0 margins for optimal outcomes.