Do elderly patients with colorectal cancer benefit from surgery and different therapeutic patterns? A real-world study based on SEER database

Currently, the treatment guidelines for colorectal cancer (CRC) in elder patients remained unclear. This study aims to investigate whether elder patients (≥70 years) with CRC benefit from surgery and different therapeutic patterns. A total of 90,347 eligible CRC patients older than 70 years were collected from the Surveillance, Epidemiology, and End Results(SEER) database. All the patients were divided into the surgery group and the no-surgery group. After being matched by propensity score matching (PSM) at a 1:1 ratio, 23,930 patients were included in our analysis. The Kaplan-Meier method and log-rank test were applied to compare overall survival (OS) and cancer-specific survival (CSS). In the age-stratified analysis (70–74; 75–79; 80–84; ≥85), the OS and CSS rates of patients in the surgery group were significantly higher than those of patients in the no-surgery group (all P < 0.001). Further analysis showed that surgery plus chemotherapysignificantly improved OS and CSS in elder colon cancer patients with III stage and IV stage compared to surgery alone. Surgery plus chemoradiotherapy significantly improved OS and CSS in elder rectal cancer patients with II stage, III stage and IV stage compared to other therapeutic patterns. Among these CRC patients with aged ≥70 years reported in the SEER database, treatment with surgical resection is significantly associated with an improved OS and CSS. Moreover, adjuvant therapyshowed a significant prognostic advantage for elder advanced CRC patients underwent surgery.