In a retrospective review of adjuvant chemotherapy for elderly (≥ 75 years) patients with stage III colon cancer, performance status and comorbidities were important treatment decision factors. Disease recurrence rates were not different for those who received adjuvant treatment vs those who did not, but 1-year and 5-year survival was significantly better for the treated group. The difference at 5 years remained apparent in multivariate analysis controlling for age, performance status, and comorbidities.