Prognostic Factors and Survival Analysis after Radical Surgery in Elderly Patients with Colorectal Cancer Based on SEER Database

<i>Background</i>: The postoperative survival time and prognosis of elderly patients with colorectal cancer are influenced by numerous factors. This study analyzes these factors to provide references for clinical prognostic evaluation. <i>Methods</i>: Elderly patients who underwent radical surgery for colorectal cancer were selected from the SEER database. Their data were analyzed using the COX proportional hazards model and the Kaplan-Meier method. <i>Results</i>: The study included 6031 patients, among whom 2902 were male (48.12%) and 3129 were female (51.88%). The racial composition included 4694 Whites (77.83%), 603 Blacks (10.00%), and 734 Asians and other races (12.17%). There were 1440 patients aged 65-69 years (23.88%), 1382 aged 70-74 years (22.91%), 1185 aged 75-79 years (19.65%), 1082 aged 80-84 years (17.94%), and 942 aged over 85 years (15.62%). The median survival time for elderly patients who died post-surgery was 49 months, with a 1-year survival rate of 92.42%, a 2-year survival rate of 86.13%, a 3-year survival rate of 68.65%, a 4-year survival rate of 51.27%, and a 5-year survival rate of 34.96%. Univariate analysis indicated that age, race, extent of tumor metastasis, tumor stage, and TNM stage were related factors influencing postoperative prognosis. The COX proportional hazards model analysis showed that age and race were independent risk factors for postoperative prognosis. Patients older than 75 years had a poorer prognosis post-surgery. Among racial groups, Whites had a longer survival period compared to Blacks. Stratified analysis revealed that for patients with local metastasis, both age and race were influential factors for prognosis, while for patients with distant metastasis, age was the influencing factor. Interaction analysis of different factors indicated that patients over 85 years of age who were either Asian or from other races, those over 85 years of age with distant tumor metastasis, and those aged 85 or older with stage IV tumors had a poorer prognosis. <i>Conclusion</i>: Age and race are independent risk factors affecting the postoperative prognosis of elderly colorectal cancer patients. The impact of these factors varies with different levels of tumor metastasis. Thus, understanding the clinical characteristics of elderly colorectal cancer patients can provide evidence for optimizing postoperative treatment and improving prognosis.