The choice of postoperative adjuvant chemotherapy for elderly patients with stage III colon cancer has been controversial in the industry. In the FU/oxaliplatin era, the ACCENT data and subgroup analysis of the MOSAIC study suggested that oxaliplatin did not provide additional benefit to older patients, while the 2010 NO16968 study showed that the oxaliplatin-containing XELOX regimen also provided benefit to stage III colon cancer patients over 65 years of age. The Kahn et al. study of patients in the community provides a different perspective and may provide some useful food for thought. The study found that age and underlying health status were the main factors influencing patients’ adjuvant chemotherapy, with physicians preferring to treat older patients who were healthier. In addition, patients over 65 years of age were more likely to interrupt chemotherapy early, but unfortunately, the study did not address the reasons for treatment interruptions. In addition, the choice of chemotherapy regimen was significantly correlated with age, with tolerability and safety for older patients remaining the main considerations, and LCAE being primarily related to the receipt of adjuvant chemotherapy. Interestingly, however, the study found that among the four different age groups of patients receiving chemotherapy, those over 75 years of age had the fewest LCAE due to chemotherapy, possibly due to the relatively better underlying health status of the older patients receiving chemotherapy, and also due to physician-initiated early discontinuation of chemotherapy to reduce LCAE. In this study, stage III elderly colon cancer patients more commonly failed to receive adjuvant chemotherapy, received platinum-free single agent chemotherapy, and had substandard duration of chemotherapy, which are believed to exist in our country as well and may be more serious. Therefore, I agree with the author’s call to expand the inclusion criteria to include more elderly patients, including those with uncomplicated morbidity, so as to produce more scientific and objective data to guide clinical practice. Since there is no long-term efficacy analysis in this article, it is not known whether this shortened regimen and lack of platinum will affect the efficacy. In the author’s opinion, although age should not be a limiting factor when selecting adjuvant chemotherapy regimens for the elderly, general physical status and concomitant morbidity may be of greater concern, and perhaps only chemotherapy that does not significantly increase toxicity or decrease dose intensity will be of real benefit to patients, and oxaliplatin should not be ruled out simply because of age. Close observation and timely management of chemotherapy-related complications by clinicians during chemotherapy to improve chemotherapy tolerance and ensure successful completion of a full course of therapy may be important prerequisites for the benefit of adjuvant chemotherapy.