Case Scenario 2:
- A 57-year old man presented for routine colonoscopy and was found to have a descending colon moderately differentiated adenocarcinoma. CEA pre-operatively was 6.
- Laparoscopic colectomy with colo-colonic anastomosis was performed. Final pathology showed a T3N2a (stage IIIb) lesion with 5/20 LNs positive. There was lymphovascular but no perineural invasion.
- Mutation testing revealed a KRAS mutation. The tumor was MSS.
- His ECOG performance status was 0.
- Following surgery, he was given adjuvant therapy with FOLFOX for 12 cycles with oxaliplatin help during the last two cycles because of grade 2 neuropathy.
- Six months later, follow-up imaging revealed recurrence and multiple metastatic hepatic lesions.
- The patient was started on FOLFIRI plus bevacizumab.