A 65-Year-Old Man Comes to the Office Due to 4-Week

A 65-year-old man comes to the office due to 4-week history of weakness and vague postprandial epigastric pain.  Medical history is insignificant.  He does not take any medications.  The patient smokes 1 pack of cigarettes daily and drinks alcohol occasionally.  Fecal occult blood test is positive.  Gastroduodenoscopy shows an antral ulcer.  Four of seven biopsies taken from the margins of the ulcer are consistent with adenocarcinoma.  Which of the following is the most appropriate next step in management?

A) CT scan
B) Exploratory laparotomy
C) Helicobacter pylori eradication
D) Laparoscopy
E) Serologic markers

Correct Answer:

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