Obstetrics & Gynaecology · Cervical Carcinoma (Risk Factors, Staging, Treatment)

FIGO 2018 revised staging of cervical cancer introduced imaging (CT/MRI/PET) and pathological lymph node assessment into the staging system. Which is now correctly classified as FIGO Stage IIIC1?

  • A Parametrial involvement on clinical examination with nodes not assessed
  • B Paraaortic lymph node involvement without pelvic node metastasis
  • C Pelvic lymph node metastasis confirmed by imaging or pathology, regardless of tumor size
  • D Hydronephrosis due to ureteral involvement on imaging
Correct answer: C. Pelvic lymph node metastasis confirmed by imaging or pathology, regardless of tumor size

Explanation

FIGO 2018 added Stage IIIC: IIIC1 denotes pelvic lymph node metastasis (by imaging 'r' or pathology 'p' suffix) and IIIC2 denotes para-aortic lymph node metastasis. This was a paradigm shift from clinical-only staging as PET-CT lymph node status significantly impacts prognosis and treatment decisions. Adding 'r' (imaging) or 'p' (pathology) subscript clarifies the method of nodal assessment. Previously, node-positive disease was not explicitly staged, so this revision dramatically changed how many patients are upstaged to IIIC. Parametrial involvement without nodal disease remains Stage IIB.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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