Elderly people are increasing in number worldwide, with prolonged life expectancy in part due to improvement of medical care. Concurrently, the number of elderly patients with pancreatic cancer (PC) is also increasing [1]. For octogenarians in particular, deciding the optimal treatment for this lethal disease is an issue of urgency. However, cancer treatment for octogenarians requires consideration of age-related physiological changes, decline in physical function, psychological issues, social issues such as life support systems, economic status, etc., as well as an individual patient's condition. The safety and feasibility of pancreatectomy for octogenarians with pancreatic cancer has been reported in several studies [[2], [3], [4], [5], [6], [7]]. Although 5-year survival is an important landmark in cancer treatment, there is limited data with long follow-up after pancreatectomy in octogenarians with potentially resectable pancreatic cancer. Moreover, prognostic factors have not been sufficiently evaluated in patients with PC with more than 5 years of follow-up after pancreatectomy.

Recently, there has been greater recognition of the importance of multi-disciplinary treatment for PC. However, the impact of neoadjuvant treatment for octogenarians with potentially resectable PC compared to upfront surgery remains controversial. Conversely, postoperative adjuvant chemotherapy has been recommended in some studies for patients who have undergone radical resection for PC, with the aim of suppressing recurrence and prolonging survival [8,9]. Some of these studies have reported that elderly patients had a significantly lower rate of completion of adjuvant chemotherapy than younger patients [3,7]. However, few octogenarians had participated in large-scale clinical trials, so there is limited information regarding the effectiveness and safety of postoperative adjuvant chemotherapy in octogenarians. Clarification of the risk factors which adversely affect completion of postoperative adjuvant chemotherapy in octogenarians with potentially resectable PC is therefore urgently required.

This study aims to evaluate how pancreatectomy for octogenarians with potentially resectable PC affects long-term survival over at least 5 years of follow-up, and to evaluate the risk factors of non-completion of adjuvant chemotherapy.