American Board of Internal Medicine (ABIM) Certification Practice Exam

Patients with colon cancer without evidence of metastasis should undergo which procedure?

1. Surgical resection of the primary tumor and lymph nodes

2. Immediate chemotherapy

3. Observation and monitoring

4. X-ray imaging every 6 months

The correct answer is: Surgical resection of the primary tumor and lymph nodes

Surgical resection of the primary tumor and lymph nodes is the standard initial treatment for patients with colon cancer who do not show evidence of metastasis. This procedure is critical because it aims to remove the tumor and any potentially affected surrounding tissue, including lymph nodes, which are common sites for cancer spread. By performing a surgical resection, the primary focus of the cancer is eliminated, reducing the risk of progression to advanced disease and improving overall survival rates. Immediate chemotherapy is typically not performed for localized colon cancer without metastasis; instead, it is reserved for cases where the cancer is more advanced or has recurred. Observation and monitoring may be appropriate in certain low-risk scenarios, but it does not address the need for definitive treatment, while imaging every six months without intervention does not effectively manage the disease. Thus, resection is essential in the management of early-stage colon cancer.