MKSAP: 58-year-old man with cancer of the ascending colon

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 58-year-old man undergoes follow-up evaluation for cancer of the ascending colon diagnosed 3 weeks ago. Colonoscopy at that time revealed a fungating mass in the ascending colon. Biopsy revealed adenocarcinoma, and additional studies showed no evidence of metastatic disease. Right hemicolectomy was performed. The pathology report showed a 4-cm primary adenocarcinoma with clear margins at resection, full-thickness penetration through the colonic wall into pericolonic fat, and 4/21 lymph nodes involved (stage III). Medical history is otherwise unremarkable, and the patient takes no medications. On physical examination, vital signs are normal. Examination of the abdomen shows well-healed surgical scars but is otherwise normal. Which of the following is the most appropriate management at this time? A. Leucovorin, 5-fluorouracil, and oxaliplatin (FOLFOX) B. Radiation therapy C. Radiation therapy and capecitabine followed by capecitabine plus oxaliplatin (CAPOX) D. Observation Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Gastroenterology Oncology/Hematology Source Type: blogs