A Mayo Clinic multicenter analysis of more than 1,400 patients found that administering chemotherapy before surgery significantly improved survival for early‑stage pancreatic cancer compared with the traditional surgery‑first approach. Investigators collected outcomes across Mayo Clinic campuses in Minnesota, Arizona and Florida, and reported that neoadjuvant sequencing increased the proportion of patients completing multimodality therapy. The findings challenge entrenched treatment algorithms and may influence guideline committees and multidisciplinary tumor boards evaluating optimal sequencing for resectable pancreatic tumors.