A 50-year-old perimenopausal woman is evaluated because of abdominal swelling. CT scan of the chest, abdomen, and pelvis shows mesenteric lymphadenopathy and a small amount of ascites but no ovarian masses. Needle biopsy specimen shows adenocarcinoma; the tumor is found to be negative for hormone receptors. The serum carcinoembryonic antigen level is normal at 2.0 ng/mL and the serum CA-125 is 1200 ng/mL (elevated). What is the best next step in her treatment?

Radiation therapy to a wide port

Positron emission tomography scan to assess other sites of disease

Bone scan to rule out skeletal metastases

A 50-year-old perimenopausal woman is evaluated because of abdominal s

1.	A 50-year-old perimenopausal woman is evaluated because of abdominal swelling. CT scan of the chest, abdomen, and pelvis shows mesenteric lymphadenopathy and a small amount of ascites but no ovarian masses. Needle biopsy specimen shows adenocarcinoma; the tumor is found to be negative for hormone receptors. The serum carcinoembryonic antigen level is normal at 2.0 ng/mL and the serum CA-125 is 1200 ng/mL (elevated). What is the best next step in her treatment?
A.	Combination chemotherapy
B.	Debulking surgery
C.	Radiation therapy to a wide port
D.	Positron emission tomography scan to assess other sites of disease
E.	Bone scan to rule out skeletal metastases
Answer» C. Radiation therapy to a wide port

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