A 38-year-old woman has FIGO Stage IB2 (4.1 cm) squamous cell carcinoma of the cervix. MRI confirms no parametrial involvement. Which treatment strategy provides equivalent oncological outcomes with better preservation of ovarian function?

• A Concurrent chemoradiation (cisplatin-based)
• B Neoadjuvant chemotherapy followed by radical hysterectomy
• C Radical hysterectomy (Wertheim's) with pelvic lymph node dissection ✓
• D Simple hysterectomy with adjuvant radiotherapy

Explanation

For Stage IB2 cervical cancer, both radical hysterectomy and concurrent chemoradiation are accepted primary treatments with equivalent cure rates. Radical hysterectomy allows ovarian transposition and preservation in premenopausal women, avoiding radiation-induced premature menopause. Concurrent chemoradiation is preferred when surgical risk is high or for stages beyond IB2/IIA2. Simple hysterectomy is inadequate for invasive cervical cancer of this stage.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

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