A 75-Year-Old Man Comes to the Office Due to Right-Sided Abdominal

A 75-year-old man comes to the office due to right-sided abdominal pain.  He has also experienced progressive fatigue and an unintentional weight loss of 7 kg (15.4 lb) in the past 2 months.  He previously refused to undergo colon cancer screening.  Medical and family history are unremarkable.  Temperature is 37.4 C (99.3 F) , blood pressure is 140/80 mm Hg, and pulse is 80/min.  Mucosal pallor is present.  There is no palpable lymphadenopathy, and cardiopulmonary examination is unremarkable.  The abdomen is soft and mildly tender in the right flank area.  Abdominal CT scan reveals a large tumor in the right colon with near obstruction of the colonic lumen as well as a 2.1-cm mass in the right hepatic lobe.  Liver biopsy of the mass confirms metastatic colon adenocarcinoma.  There is no evidence of other metastases.  Which of the following is the most appropriate next step in management of this patient?

A) Chemotherapy and radiation
B) Chemotherapy only
C) Liver transplantation
D) Palliative care only
E) Surgical resection

Correct Answer:

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