Nearly every published study related to the treatment of patients with pancreatic ductal adenocarcinoma (PDAC) opens with a description of the poor long-term survival associated with the diagnosis, and many further emphasize that resection is the only potentially curative treatment option. While both points are for the most part factual, neither really tells the whole story. With contemporary systemic therapy regimens, long-term survivors are increasingly identified.1 There is also an evolving understanding that while surgery is potentially curative, this is particularly the case when it is not used as a stand-alone intervention but rather incorporated as part of multimodality therapy (MMT) that includes chemotherapy, concurrent chemoradiotherapy, or both.