FIGO 2018 revised staging for cervical cancer now allows imaging and pathological findings to modify clinical staging. A patient with cervical cancer invading the parametrium but not reaching the pelvic sidewall, with a pelvic lymph node metastasis confirmed on MRI, is now staged as:

• A Stage IIB
• B Stage IIIB
• C Stage IVA
• D Stage IIIC1 ✓

Explanation

In FIGO 2018 staging, Stage IIIC was newly added for nodal involvement regardless of tumor size or local extent: IIIC1 = pelvic lymph node metastasis only, IIIC2 = para-aortic lymph node metastasis. The parametrial invasion alone would be IIB, but nodal involvement upgrades the stage to IIIC1 regardless. This represents a major shift from the 2009 FIGO staging that was purely clinical. The addition of imaging and pathological staging using subscript 'r' (radiology) or 'p' (pathology) notation allows better prognostication. Stage IIIC1 has a significantly worse prognosis than IIB and is treated with concurrent chemoradiation.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.