Treatment of colorectal cancer in the elderly: a review of the literature.

Although major progress has been achieved in the treatment of colorectal cancer, there are still several questions open for discussion concerning the management of elderly colorectal cancer patients. We conducted a review of the available literature concerning the use of adjuvant chemotherapy, palliative chemotherapy and surgery in elderly patients with colorectal cancer, using data from meta-analyses, non-systematic reviews and individual trials. All report similar survival benefits with adjuvant and palliative chemotherapy in elderly patients in comparison with younger age groups. Data on treatment-related side effects did not reveal a different toxicity profile for elderly patients. Efficacy and safety data were similar but more difficult to interpret concerning surgery, so this review is inconclusive about the proper use of this treatment modality in the elderly population. It is demonstrated that there is significant gain from chemotherapy in the adjuvant and palliative management of colorectal cancer patients irrespective of age. We, therefore, conclude that all patients should receive the most intensive treatment thought to be effective and safe, according to their biological age and comorbidities.