A nationwide protocol in the Netherlands led to a significant increase in surgical resections for locally advanced pancreatic cancer (LAPC) while maintaining safety standards.

• Resection rates tripled from expected 53 to 155 patients, achieving an 86% resection rate among those explored.
• Major morbidity was 44% and mortality only 0.6%, both within safety benchmarks.

Surgeons should consider the feasibility of implementing multidisciplinary approaches to enhance surgical opportunities for LAPC patients.

In resected pancreatic ductal adenocarcinoma (PDAC), preoperative circulating tumor DNA (ctDNA) positivity is a strong predictor of poor overall and recurrence-free survival.

• Preoperative ctDNA positivity is linked to worse overall survival (hazard ratio [HR] 2.53) and recurrence-free survival (HR 2.28).
• Postoperative ctDNA positivity shows even stronger associations with worse survival outcomes (HR 5.15 overall, HR 3.12 recurrence-free).
• Circulating tumor cells (CTCs) also indicate inferior recurrence-free survival, but further assay standardization is needed.

Surgeons should consider ctDNA testing pre- and postoperatively to better inform prognosis and treatment strategies for PDAC patients.

An increased area deprivation index (ADI) correlates with a higher risk of 90-day mortality after major hepatectomy, particularly due to posthepatectomy liver failure.

• Patients in the upper tier of ADI had a 5.47-fold increased risk of 90-day mortality (p = .043) compared to lower tiers.
• 4.9% of patients died within 90 days post-surgery, predominantly from liver failure.
• Morbidity was associated with factors like hepaticojejunostomy and cholangiocarcinoma but not with ADI.

Surgeons should consider using ADI in preoperative assessments to better prepare high-risk patients.