A 25-year-old nulliparous woman desires fertility preservation. Colposcopy-directed biopsy confirms Stage IA2 cervical squamous cell carcinoma (depth 4.5 mm, width 6 mm). The BEST fertility-preserving surgical option is:
- A Radical trachelectomy (vaginal or abdominal) with pelvic lymph node dissection ✓
- B Cold knife conisation alone
- C Simple trachelectomy without lymph node dissection
- D Laser ablation with close surveillance
Correct answer: A. Radical trachelectomy (vaginal or abdominal) with pelvic lymph node dissection
Explanation
Stage IA2 (3.1–5.0 mm depth) carries a 5–8% pelvic lymph node metastasis risk, necessitating lymphadenectomy in addition to excision. Radical trachelectomy (abdominal or vaginal) with pelvic lymph node dissection removes the cervix, parametrium, and upper vagina while preserving the uterine corpus and is the standard fertility-preserving procedure for IA2–IB1 (<2 cm). Simple trachelectomy without parametrectomy is insufficient for IA2 disease.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.