To identify the factors affecting the prognosis of elderly patients with colorectal cancer (CRC), so as to provide theoretical reference for clinical decision-making.

The clinicopathological data of 48 elder patients age ≥80 years old with CRC who underwent surgery at the General Surgery Department of the Air Force Medical Center from January 2014 to December 2020 were collected. Univariate and multivariate Cox regression analyses were performed to identify the risk factors that may affect the surgical prognosis of elderly CRC patients, explore their role and significance in evaluating the surgical prognosis of elderly CRC patients, and evaluate their clinical value in predicting the prognosis by drawing the ROC curve and calculating the area under the curve (AUC).

A total of 48 elder patients with CRC were included in the study. Up to August 1, 2021, the median follow-up time was 36.46 months, the follow-up rate was 100%, and the case fatality rate was 41.67%. Univariate Cox regression analysis showed that preoperative fibrinogen to albumin ratio (FAR; P=0.041), carcinoembryonic antigen (CEA; P=0.023), intravascular tumor thrombus (P=0.039), and length of stay in ICU (P=0.009) were risk factors affecting the prognosis of elderly CRC patients. Multivariate Cox regression analysis showed that preoperative FAR (P=0.003), CEA (P=0.022), cancer nodule (P=0.035), and length of stay in ICU (P=0.013) were independent risk factors for the prognosis of elderly CRC patients. ROC curve analysis showed that the AUC of FAR combined with CEA (AUC=0.793) was better than the AUC of FAR (0.731) or CEA (0.666).

Preoperative FAR, CEA, cancer nodule, and length of stay in ICU are independent risk factors for surgical prognosis of elderly CRC patients. Combined detection of FAR and CEA can more effectively evaluate the surgical prognosis of elderly CRC patients.