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Introduction: The Balducci classification separates three groups of elderly patients: group 1 with 'fit' elderly, group 2 with intermediate patients, and group 3 with 'frail' patients. Patients and methods: The aim of this retrospective study was to compare the therapeutic proposals of the geriatrician (G) and the gastroenterologist (HGE) in patients older than 70 years old, followed in a specialized unit for a gastrointestinal cancer. Results: 62 patients, median age 81 years old [71-94], were included in this study. Group 1: 24.2%, group 2: 50%, group 3: 25.8%. The primary site was colorectal in 51,6%, pancreatic in 21%, oesogastric in 16.1%, liver in 6.5%, non-Hodgkin lymphomas in 3.2% and digestive endocrine tumors in 1.3%. A chemotherapy (CT) was proposed to all the patients in group 1 (agreement G/HGE: 100%) and best supportive care (BSC) was proposed to all the patients in group 3 (agreement G/HGE: 100%. In the group 2, patients received CT in 48.4% and BSC in 51.6%. G and HGE agreed in 77.4%, for CT (54.8%) or BSC (22.6%) but disagreed in 22.6% and none patient received CT in this situation. In patients of group 2 treated by CT, the CT regimen, the CT tolerance and efficacy were the same as in group 1. The median overall survival was 19.2 months in group 1, 5.4 months in group 2 (7.3 months if CT received, 0.8 month if BSC received) and 0.8 month in group 3. Conclusion: Treatment recommendations appear to be consensual between G and HGE for fit and frail patients. Treatment decision is more difficult for intermediate patients. In this group, about half of the patients may benefit from an active treatment and their prognosis is close to what is observed for group 1, whereas other patients are close to those from group 3. In group 2, differences between G and HGE might be explained by the fact that G, making their decision from the Comprehensive Geriatric Assessment, often support an active treatment ('the patient can tolerate the treatment'), while HGE, making their decision on the prognosis and potential benefit of the treatment, depending on tumor localization, sometimes propose BSC ('CT is feasible but no expected benefit'). These results confirm the importance, mainly in group 2 patients, of a multidisciplinary evaluation in elderly patients with a gastrointestinal cancer.