Radical trachelectomy is a fertility-sparing surgical option for cervical carcinoma. Which stage/size is the OPTIMAL candidate?
- A Stage IIB, any size
- B Stage IA2–IB1, tumor ≤2 cm, no lymph node involvement, squamous or adenocarcinoma histology, distance from internal os >1 cm ✓
- C Stage IB2, tumor 2–4 cm
- D Any Stage I if patient age is under 35 years
Correct answer: B. Stage IA2–IB1, tumor ≤2 cm, no lymph node involvement, squamous or adenocarcinoma histology, distance from internal os >1 cm
Explanation
Radical trachelectomy (vaginal or abdominal) removes the cervix with surrounding parametrium but preserves the uterine body, allowing future pregnancy. Optimal candidates are Stage IA2–IB1 with tumor ≤2 cm, no lymphovascular space invasion or lymph node involvement, tumor confined to the cervix, and endocervical margin ≥1 cm from the internal os to ensure adequate margin. Recurrence rates are comparable to radical hysterectomy at this stage; subsequent pregnancy is possible in approximately 50% of women who attempt conception.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.