Under FIGO 2018 revised staging for cervical cancer, a patient has a 4.2 cm cervical tumor with MRI demonstrating parametrial involvement. Pelvic nodes show a 12 mm node with central necrosis. What is the FIGO 2018 stage?

• A Stage IIB (parametrial involvement only)
• B Stage IIIB (pelvic sidewall involvement or hydronephrosis)
• C Stage IIIC2 (para-aortic lymph node metastasis)
• D Stage IIIC1 (pelvic lymph node metastasis) ✓

Explanation

FIGO 2018 added Stage IIIC (lymph node metastasis) for the first time, separating pelvic (IIIC1) from para-aortic (IIIC2) lymph node involvement. Imaging (CT, MRI, PET) can now be used for staging. This patient has parametrial involvement (consistent with IIB) but also has pelvic node metastasis (necrotic node = pathological). When both are present, the higher stage (IIIC1) supersedes. The subscript 'r' (radiological) or 'p' (pathological) is added: IIIC1r or IIIC1p depending on imaging vs. biopsy confirmation.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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