Debra Bynum

Adjuvant Chemotherapy in Older Patients With Stage III Colon Cancer: An Underused Lifesaving Treatment

absolute 5-year improvement in survival for all patients of 7% favoring chemotherapy (64% for surgery alone v 71% for surgery and chemotherapy), and similar survival benefits were seen in the 506 patients in this data set who were older than 70 years of age. Moreover, there was no relationship between age and chemotherapy toxicity, including nausea and vomiting, stomatitis, and diarrhea; however, leucopenia was more common in older patients in two of the trials. A key goal of the Sanoff et al 4 analysis was to determine the value of oxaliplatin when added to fluoropyrimidine (fluorouracil [FU] or capecitabine) therapy. Of those patients who received chemotherapy, oxaliplatin was administered to 46%, 25%, and 7% of patients age 75 to 79, 80 to 84, and 85 years or older, respectively. There was a trend for improved survival with oxaliplatin (HR, 0.82; 95% CI, 0.51 to 1.33) that corresponded to an absolute 5% improvement in survival at 3 years compared with fluoropyrimidines alone; these results are similar to the HRs reported in the MOSAIC (Multicenter International Study of Oxaliplatin/FU/Leucovorin in the Adjuvant Treatment of Colon

Teaching medical students the art of the 'write-up'

The creation of a complete ‘write–up’ continues to be essential to the clinical learning experience for medical students. The ability to document a clinical encounter is a key communication skill and Core Entrustable Professional Activity for entering residency.