Lecture : The survival rate of pancreatic cancer is still dismal and the rate of its improvement is also slow, compared with other abdominal malignancies. Therefore, significant efforts have been dedicated to improve outcomes of pancreatic cancer treatment in many clinical studies, basic researches and translational studies. Especially in the case of clinical studies, prospective randomized controlled trial (RCT) is the one that can achieve the highest level of evidence among those studies. Recently, a paradigm shift has been made in the treatment of pancreatic cancer. The ideas about importance of neoadjuvant treatment and the minimally invasive surgery in pancreatic cancer have emerged that were considered impossible in the past. These attempts were based on the evidence of many clinical studies, and more studies try to focus on these subjects to get higher levels of evidences. However, there are several limitations in performing prospective RCTs in pancreatic cancer research especially in pancreatic cancer surgery. Since only 20% of total pancreatic cancer patients are operable, it takes a long time to recruit enough eligible patients for the RCTs. Moreover, pancreatic cancer surgery is difficult to unify procedures because of complexity of the surgery. Nevertheless, the Korean Pancreatic Surgery Group has provided a significant evidence for the treatment of pancreatic cancer through many multicenter RCTs. Today, I would like to review the research conducted by the Korean Pancreatic Surgery Group and introduce the RCTs that are going on in Korea and other countries.