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Margin-negative (R resection is the only potentially curative treatment for patients with pancreatic ductal adenocarcinoma (PDAC). Pre-operative multi-agent chemotherapy alone (MAC) or MAC followed by pre-operative radiotherapy (MAC+RT) may be used to improve resectability and potentially survival. However, the optimal pre-operative regimen is unknown. Patients with non-metastatic PDAC from 2006 to 2016 who received pre-operative MAC or MAC+RT before oncologic resection were identified in the National Cancer Database. Univariable and m