Abstract: While the concept of "precision treatment" has been widely adopted in pancreatic cancer, its clinical understanding often diverges from the original vision of precision medicine, frequently reduced to genetic testing or molecularly targeted therapies, while overlooking the multidimensional nature of precision decision-making from a surgical perspective.In 2024, the Trans-Atlantic Pancreatic Surgery Consortium validated the ABC stratification system, upgrading resectability assessment from purely anatomical imaging to a three-dimensional framework incorporating Anatomy, Biology, and Condition.However, rapid advances, including KRAS G12D inhibitors, Claudin18.2-targeted antibody-drug conjugates, individualized mRNA neoantigen vaccines, liquid biopsy-guided minimal residual disease monitoring, and AI-assisted decision platforms, demand a more comprehensive framework.This review systematically examines the current status and recent breakthroughs across multiple dimensions of precision treatment from a surgical standpoint.And explore the application prospects of multi-factor data integration and artificial intelligence in precise surgical decision-making, with the aim of providing a practical path for individualized treatment of pancreatic cancer.

Key words: pancreatic cancer, precision treatment, artificial intelligence, molecular subtyping, neoadjuvant therapy, targeted therapy