Living in socioeconomically disadvantaged areas significantly reduces survival in patients with nonmetastatic pancreatic cancer, even with guideline-concordant treatment.

• Patients in high deprivation areas had a 1.9 times higher risk of decreased survival compared to those in lower deprivation areas.
• Not receiving guideline-concordant treatment increased the risk of poor outcomes by 1.7 times.

Surgeons should consider the socioeconomic context when selecting patients for treatment and address barriers to care.

• Factors like aggressive tumor biology and high comorbidity also contribute to worse survival outcomes.