Tracking CA19-9 levels after pancreatic cancer resection can better guide surgical prognostication and patient outcomes.

• Patients with normalized CA19-9 levels post-surgery had a median time-to-treatment failure of 693 days, while those with persistent elevation faced just 138 days.
• Neoadjuvant therapy patients presented with much higher pre-treatment CA19-9 (273 u/ml) compared to surgery-first patients (19 u/ml).

Evaluating CA19-9 trajectories is crucial for identifying high-risk patients after surgery, moving beyond single value assessments.