Clinical atlas of rectal cancer highlights the barriers and insufficient interventions underlying the unfavorable outcomes in older patients

•Clinical atlas of rectal cancer demonstrated similar clinicopathological features and tumor biology between the old and young populations.•Old patients with rectal cancer are characterized by frailty attributed to more comorbidities and worse nutritional status.•This study showed the old population might get the benefit of well-being by improving the insufficient cancer care that is associated with an increased risk of recurrence and death.