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Background: The patterns of metastatic relapse for Stage III colorectal cancer (CRC) are known to be influenced by the primary site and mutation status. Whether the use of adjuvant therapy also influences recurrence patterns, due to a variable chemotherapy impact by metastatic site, has yet to be explored. Patient age 70 years has consistently been associated with a lack of benefit from the addition of oxaliplatin to a fluoropyrimidine (FP) chemotherapy. Methods: Data from a multi-site CRC database that prospectively captures, patient, tumour, treatment and outcome data was examined. Patients with de novo metastatic or multiple primary tumours were excluded. Patterns of recurrence were analysed by receipt of surgery and adjuvant chemotherapy (S + AC) or surgery alone (S alone) and by age 70 years and <70 years old. Results: Of 701 patients with stage III colon cancer 397 were male, median age was 68 …