A 45-year-old woman is diagnosed with cervical carcinoma Stage IIIB (hydronephrosis and non-functioning kidney due to ureteric involvement). Which of the following statements about her staging and treatment is CORRECT?
- A Staging is done surgically by lymphadenectomy and biopsy
- B PET-CT findings of para-aortic lymph node metastasis would upstage her to Stage IVB ✓
- C Cervical carcinoma staging is clinical; imaging can supplement but does not change clinical stage
- D Stage IIIB requires radical hysterectomy followed by adjuvant radiation
Correct answer: B. PET-CT findings of para-aortic lymph node metastasis would upstage her to Stage IVB
Explanation
In the FIGO 2018 updated staging of cervical carcinoma, imaging (CT, MRI, PET-CT) and pathological findings are now incorporated into staging. PET-CT detection of para-aortic lymph node involvement would classify her as Stage IIIC2 (para-aortic nodal disease), not IVB. Stage IVB is reserved for distant metastases (lung, liver, bone). Prior to 2018 FIGO, staging was purely clinical, but this has changed. Stage IIIB (ureteric obstruction/hydronephrosis) is treated with concurrent cisplatin-based chemoradiation, not surgery.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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