A nationwide protocol led to significantly increased resection rates for locally advanced pancreatic cancer (LAPC) in the Netherlands, improving potential long-term survival.

• Resection rates jumped to 86%, nearly three times the expected number.
• In-hospital major morbidity was 44%, while mortality was just 0.6%, both within safety benchmarks.

Implementing international best practices is feasible and could enhance outcomes for selected LAPC patients.

• Extended resections were common, with 77% of patients undergoing complex procedures.