A 38-year-old woman presents with post-coital bleeding for 4 months. Speculum examination reveals a friable, exophytic cervical lesion measuring 5 cm. Biopsy confirms squamous cell carcinoma. MRI pelvis shows parametrial invasion bilaterally without reaching the pelvic sidewall. Bladder and rectum are uninvolved. What is the FIGO 2018 stage?

• A Stage IB3
• B Stage IIIB
• C Stage IIA2
• D Stage IIB ✓

Explanation

In the FIGO 2018 staging for cervical cancer, Stage IIB denotes parametrial invasion that does not extend to the pelvic sidewall. Stage IIIB would require the tumor to reach the pelvic sidewall or cause hydronephrosis. Stage IB3 refers to a tumor >4 cm confined to the cervix. The standard treatment for Stage IIB is concurrent chemoradiation (cisplatin-based) with brachytherapy boost, as surgery is not indicated once there is parametrial involvement.

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

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Written and medically reviewed by the StethoPrep medical team.