Question 3. 
 
A 43-year-old man presented with vomiting and 4-kg weight loss. His performance status was 
1. He was found to have a pre-pyloric gastric carcinoma gastric outlet obstruction. A CT scan 
showed no metastases. 
 
What is the most appropriate next step? 
 
A chemo-radiation 
B neoadjuvant 

chemotherapy 

C palliative 

bypass 

D radical 

resection 

E self-expanding 

stent