Tumori del colon retto

The increasing aging of the population points out the problem of an evidence-based approach to the elderly (≥ 65 years old) in the setting of adjuvant chemotherapy, whose benefit is established only in younger patients. Currently the cornerstone trials in these fields are planned for patients aged less than 65 and the extrapolation of these results to elderly patients is not methodologically correct. On the other hand, the search for a survival benefit should be balanced by the acknowledgement that aging gradually reduces the functional reserves of the body, so such treatments could be harmful. The favorable outcomes were mostly related to breast cancer, due not only to its high prevalence and social impact, but also to the dual opportunity of chemotherapy and hormonal treatment. Chemotherapy has also proved effective in colorectal cancer and to a lesser extent in lung cancer, despite the limits of such studies. Some recent clinical trials have however demonstrated that fit elderly patients may show similar outcomes in comparison with their younger counterparts. These results then display again the need for a comprehensive geriatric assessment in treatment planning, also in the adjuvant setting, in order to balance the benefit of this treatment with the possible harms linked to age-associated disorders.