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
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Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Gastroenterology Oncology/Hematology Source Type: blogs
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