Fragmented care for pancreatic cancer patients at high-volume centers leads to delays in chemotherapy but not worse surgical outcomes.

• One-third of patients (n = 124) received fragmented care, often living farther from the center.
• Delayed chemotherapy initiation occurred in 17.6% of fragmented care patients compared to 5.6% of those receiving care solely at the center.

Although fragmented care didn’t affect resection rates or overall survival, it presents challenges in therapy timing.

• Patients receiving fragmented care predominantly came from rural and disadvantaged areas.