Colorectal cancer (CRC) is a common malignancy in the elderly. Randomized trials have demonstrated that adjuvant and palliative chemotherapy for CRC improves survival and quality of life. Unfortunately, there is a lack of evidence-based data about elderly patients to guide decisions regarding therapy. Clinical trials have generally excluded the vulnerable elderly population commonly seen in practice and included the robust elderly, who seem to benefit from chemotherapy as much as younger patients. The existing literature consists of pooled datasets from large studies and a few small dedicated trials on chemotherapy and its toxicity in elderly patients with CRC. We present illustrative data in this article and summarize our recommendations for managing the disease in elderly patients in a variety of clinical circumstances.
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