Radical trachelectomy is a fertility-preserving option for early cervical cancer. The most appropriate candidate for vaginal radical trachelectomy is:
- A Stage IB1 squamous cell carcinoma, 1.8 cm, no LVSI, negative lymph nodes ✓
- B Stage IB2 squamous cell carcinoma, 4.5 cm, with no lymph node involvement
- C Stage IIA1 carcinoma involving the upper third of vagina
- D Stage IB adenocarcinoma with bulky disease 3.5 cm
Explanation
The optimal candidate for fertility-sparing vaginal radical trachelectomy (Dargent procedure) has: FIGO Stage IA2 or IB1, tumor size <2 cm (some centers accept up to 2 cm), squamous or adenosquamous histology, no lymphovascular space invasion (LVSI), negative sentinel lymph nodes, and desire for future fertility. Stage IB2 (>4 cm) and adenocarcinoma >2 cm are associated with higher recurrence risk and are relative contraindications. Recurrence rate is ~5% and pregnancy rates are approximately 50–70% in series from experienced centers. The procedure involves cervical amputation 5–10 mm above the vaginal fornix with permanent cerclage placement.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.