A 35-year-old nulliparous woman has FIGO Stage IB1 squamous cell carcinoma of the cervix (2.5 cm tumor, no lymphovascular invasion, no parametrial involvement on MRI). The fertility-sparing surgical option of choice is:
- A Radical trachelectomy with pelvic lymphadenectomy ✓
- B Large loop excision of transformation zone (LLETZ) with pelvic lymphadenectomy
- C Simple trachelectomy without lymphadenectomy
- D Neoadjuvant chemotherapy followed by conization
Correct answer: A. Radical trachelectomy with pelvic lymphadenectomy
Explanation
Radical (Dargent) trachelectomy involves removal of the cervix, upper vagina, and parametria while preserving the uterine corpus, combined with pelvic lymphadenectomy for nodal staging. It is appropriate for Stage IB1 tumors ≤4 cm in carefully selected young women desiring fertility. LLETZ with lymphadenectomy is insufficient for parametrial clearance at this stage. Simple trachelectomy without lymphadenectomy is inadequate for radical treatment. Neoadjuvant chemotherapy followed by conization is not a standard validated approach.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.