Pancreatic cancer is the most malignant gastrointestinal tumor, and its incidence has been increasing in recent years. Our team conducted an epidemiological survey of Shanghai residents (31 hospitals in Shanghai) during the last 10 years (2001-2009) and found that the incidence of pancreatic cancer increased from 9.86% to 15.23%; however, this was accompanied by a high patient mortality rate, which remained close to the incidence rate even though the means of diagnosis and treatment were significantly improved (Cancer Lett, 2014), which is comparable to the current international trends as a whole. To date, radical surgery remains the only hope for long-term survival of patients with pancreatic cancer. However, despite the improvement of surgical techniques, the expansion of surgical scope, the increase of surgical safety, and the enhancement of adjuvant strategies such as the combination of postoperative radiotherapy and chemotherapy, the 5-year postoperative survival rate of patients with resectable pancreatic cancer still hovers around 20%, and about 80% of pancreatic cancer patients have difficulty surviving beyond 5 years despite various treatments. Our center (including Huashan Hospital and Cancer Hospital of Fudan University) summarized 800 radical resected pancreatic cancer patients treated by the same team (led by Prof. Quanxing Ni) with complete data over 10 years and found that the overall survival time (overall survival) of patients did not significantly increase over 10 years. It seems that a single operation cannot radically improve the survival of pancreatic cancer patients. Technical maneuvers are the Prince and Princess”, as Professor Blake Cady said at the 2007 American Surgical Oncology Conference, “In the world of surgical oncology, Biology is King Selection is Queen. A full understanding of the biological characteristics of tumors (including pancreatic cancer) is the core of truly “conquering” the tumor barrier and winning the war against cancer. Professor Liu Liang has been engaged in the research of “the more tumors are treated, the more they spread” in the past 10 years, and has discovered that interventional chemotherapy itself causes tumor hypoxia and activates β-catenin signaling in cancer cells, which increases lung metastasis; he also discovered that the anti-angiogenic drug Sorafinib down-regulates the metastasis of cancer cells. The anti-angiogenic drug Sorafinib was found to downregulate HTATIP2 molecules in cancer cells to promote tumor metastasis, and the commonly used chemotherapeutic drug oxaliplatin was also found to cause epithelial-mesenchymal transition in cancer cells and increase malignant potential. The related findings were published in the mainstream international journals Clin Cancer Res (2010), Cancer Sci (2010), Gastroenterology (2013), and in the domestic “Reference News”, “Wen Wei Po”, and “The Chinese Journal of Cancer”. “Wen Wei Po”, “Liberation Daily”, etc. In this study, which lasted for 2 years, Prof. Liu Liang’s group, in collaboration with the Department of Mathematics of Fudan University and the Department of Biostatistics of Shanghai Jiaotong University, systematically analyzed the serological data and biological samples of 164 patients with radical pancreatic cancer in the Institute of Pancreatic Cancer of Fudan University over 5 years, and retrospectively analyzed the data of patients with locally progressive (257 cases) and metastatic (384 cases) pancreatic cancer, and found that preoperative patients with “(1) The median survival of these patients, even if they underwent radical surgical resection and recovered well (discharged 2 weeks after surgery), was only 5.1 months, and the 1-year survival rate was almost zero. The 1-year survival rate is almost zero. (2) The postoperative survival time of this group of patients was not significantly different from that of patients with locally progressive disease who could not undergo surgery due to advanced tumor (P > 0.05). (3) The tumor recurrence rate in this group of patients was greater than 90% six months after surgery, suggesting the existence of “occult metastasis” in the body before surgery. All the results were further confirmed by the data of 227 radical resection patients in Huashan Hospital of Fudan University during 10 years. Recently, this groundbreaking finding was accepted in full by the International Journal of Cancer, which has significant clinical and scientific implications. Professor Liu Liang believes that for patients with CEA+/CA125+/CA19-9 ≥1000U/ml pancreatic cancer, neoadjuvant therapy should be used first even in the early stage of the tumor to control the “hidden metastases” in the body as early as possible. “In addition, the scope of surgery should be expanded, such as expanding the scope of surgery. In addition, simply expanding the scope of surgery, such as expanding the lymphatic drainage in the region and replacing artificial blood vessels, is not effective for this group of patients; patients with difficult resection can adopt a relatively conservative treatment strategy, without blindly pursuing surgical cure.