The FIGO 2018 revised staging of cervical carcinoma made a paradigm shift by incorporating imaging findings for the first time. Which is the specific addition that changed Stage IIIC classification?

• A Parametrial invasion detected on MRI now allows upstaging from IIA to IIB
• B Hydronephrosis diagnosed on ultrasound now places a patient in Stage IVA
• C Bladder bullae on imaging alone (without cystoscopy) now allows Stage IVA classification
• D Pelvic lymph node metastasis (Stage IIIC1) and para-aortic lymph node metastasis (Stage IIIC2) are now included, based on imaging or pathology ✓

Explanation

The FIGO 2018 revision introduced Stage IIIC to account for regional lymph node metastasis for the first time in cervical cancer staging. Stage IIIC1r/p = pelvic lymph node metastasis (r = radiological, p = pathological); Stage IIIC2r/p = para-aortic lymph node metastasis. This was a major change because prior FIGO staging was clinical only and did not incorporate lymph node status despite its critical prognostic significance. Parametrial invasion has always defined Stage IIB; bladder invasion (cystoscopic biopsy confirmed) remains Stage IVA — imaging alone does not suffice for bladder staging.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.