Background Small intestine adenocarcinoma is a scant disease which has no adequate clinic trials, so its prognostic factors are still unclear especially in elderly patients. In this article, We aimed to explore the clinicopathology presentation, treatments, outcomes and predictors of small intestine adenocarcinoma patients who aged 65 years or older. Methods We retrieved clinicopathology data of small intestine adenocarcinoma patients diagnosed between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database. we clarified patients into two groups: surgery and non-surgery group, and conducted propensity score matching (PSM) to compare survival outcoming. We identified the prognostic indicators for cancer-specific survival (CSS) and overall survival (OS) by Cox proportional hazards model. Results In total, 1018 eligible cases were enrolled, with a median survival of 16 months, the 3-year OS and CSS rates was 36% and 41.7%, and the 5-year OS and CSS rates was 26.5% and 33.3%. Multivariate analyses revealed that age, grade, tumor stage, surgery and chemotherapy were independent prognostic factors for OS, while grade, tumor stage, surgery, radiation and chemotherapy were independent factors for CSS. After PSM, only surgery and tumor stage(AJCC 6th) were independent prognostic factors for OS and CSS. Conclusion Surgery could bring benefit to survival for elderly SBA patients, and early stage of disease was another significant prognostic factor.

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