• A robotic approach combined distal splenopancreatectomy and left nephrectomy in a complex case with renal infiltration from pancreatic adenocarcinoma.
• The procedure achieved negative margins and involved a multidisciplinary team to minimize conversion risk and enhance oncological outcomes.

The patient was discharged on postoperative day 6, indicating a favorable recovery.

• Pathology revealed T4 cancer with two positive lymph nodes, highlighting the need for careful patient selection in advanced cases.

Multivisceral resection (MVR) for pancreatic ductal adenocarcinoma shows similar short-term outcomes to standard resection, but poorer long-term survival rates among selected patients.

• 2-year overall survival rate for MVR is 33.3% vs. 49.9% for standard resection (p=0.006).
• 2-year disease-free survival rate is 11.3% for MVR vs. 25.9% for standard resection (p=0.018).

Surgeons should consider MVR for patients with suspected organ invasion, balancing potential immediate benefits against long-term prognosis.

• Both groups had similar hospital stays (11.4 vs. 12.6 days, p=0.094) and major complications (23.8% vs. 19.0%, p=0.566).

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.