Heart Failure in a Patient With Metastatic Well-Differentiated Neuroendocrine Tumor.

Patients with neuroendocrine malignancy with liver metastases are at risk for carcinoid heart disease which, if left unchecked, can lead to heart failure. This case study demonstrates a clinical situation in which an advanced practitioner performed a thorough workup consisting of lab work and imaging studies, including echocardiogram, cardiac MRI, and dotatate PET/CT, as well as outside record review and comprehensive physical exam. Early detection, intervention, and control of disease are paramount to prevent potentially life-limiting carcinoid heart disease.

Characteristics and clinical outcomes in young-onset cholangiocarcinoma.

Background: While the incidence of cholangiocarcinoma is rising, little is known about young-onset disease. We compared clinical characteristics and outcomes between patients with young-onset cholangiocarcinoma, diagnosed between the ages of 18 and <50 years, and patients with typical-onset cholangiocarcinoma, diagnosed at age 50 years or greater.

Methods: We used the National Cancer Database to identify patients with young-onset cholangiocarcinoma (n = 2520) and typical-onset cholangiocarcinoma (n = 23,826).

Trends in Adjuvant Chemotherapy Use Among Stage III Colon Cancer in Non-Elderly and Low Comorbidity Patients.

Background: Adjuvant chemotherapy for stage III colon cancer is underutilized in the United States. The aim of this study was to assess the use of adjuvant chemotherapy in younger and medically fit patients and analyze the socioeconomic factors associated with its utilization.

Methods: Using the National Cancer Database from 2004 to 2015, we selected stage III colon cancer patients between age 18 to 65, Charlson-Deyo Comorbidity Index (CDCI) of 0 or 1, and those that survived at least 12 months after surgery.

Oxaliplatin-induced Pulmonary Toxicity: A Rare but Serious Complication.

The FOLFOX regimen (oxaliplatin, leucovorin, and 5-fluorouracil) is FDA approved for use in patients with colorectal cancer and other gastrointestinal malignancies. The initial phase III randomized controlled trials that led to FDA approval of oxaliplatin with leucovorin and 5-fluorouracil showed a less than 1% incidence of pulmonary fibrosis and grade IV pulmonary toxicities. Here we describe two cases of pulmonary toxicity in patients with metastatic colorectal cancer treated with FOLFOX and briefly review the literature regarding oxaliplatin-induced pulmonary toxicity.