Confronting an aging society, the demand to treat extremely elderly cancer patients is increasing. With the development in surgical technique and management, curative resection in elderly cancer patients aged ≥ 80 years has been demonstrated to achieve acceptable postoperative morbidity and long-term survival rates.1,2 However, the feasibility of palliative surgery in this population has rarely been discussed because of its palliative nature. Through our clinical experience in Japan, one of the most long-lived countries, a concern arose that extreme old age might negatively impact short-term outcomes after gastrojejunostomy (GJ) for malignant gastric outlet obstruction (mGOO). In order to determine the specific characteristics of GJ in very elderly cancer patients, we conceived a multi-institutional retrospective study.