A 65-year-old man presents with a change in bowel habit and fresh rectal bleeding. Colonoscopy reveals an annular carcinoma of the sigmoid colon. CEA is 12 ng/mL. CT staging shows the tumour limited to the bowel wall with no nodes involved (T2N0M0). What is the definitive treatment?
- A Sigmoid colectomy alone ✓
- B Sigmoid colectomy with adjuvant chemotherapy
- C Neoadjuvant chemoradiotherapy followed by surgery
- D Hartmann's procedure with permanent colostomy
Correct answer: A. Sigmoid colectomy alone
Explanation
T2N0M0 (Stage I) sigmoid colon carcinoma is managed by sigmoid colectomy with primary anastomosis and adequate lymphovascular clearance. Adjuvant chemotherapy is generally reserved for Stage III (node-positive) or high-risk Stage II disease. Neoadjuvant chemoradiotherapy is used for rectal cancers, not colon cancers. Hartmann's procedure is reserved for emergency resection when primary anastomosis is unsafe (e.g., obstruction or perforation).
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.