A total of 15,731 pancreatic cancer cases were registered by the Pancreatic Cancer Registration Committee of the Japan Pancreas Society (JPS) in a period of over 14 years. Tumor resection was performed in 35.4% of the total. The five-year actuarial survival rate of resected cases was 17.5%. 130 patients histologically confirmed had long-term (over 5 years) survival, among whom were only 7 patients with n3, pv3, ly3, a3 and pl (+) as histological criteria by JPS. The combined use of radiation therapy and chemotherapy after resection for Stage I, Stage II and Stage III disease proved effective. According to the National Cancer Data Base (NCDB), though the resection rate was only 14.2%, the long-term survival rate was similar to that by JPS, because Stage IV disease was only 8% of patients who received resection in NCDB's report. Selected patients seemed to be allowed to undergo resection. We concluded that it was very important to select patients to improve therapeutic results for pancreatic cancer.