Under FIGO 2018 cervical cancer staging, which of the following findings, detected only on MRI (not clinical examination), qualifies for upstaging compared to the previous FIGO 2009 system?
- A Parametrial invasion detected on MRI but not on bimanual examination
- B Pelvic lymph node metastasis (≥10 mm short axis) on MRI — upstages to IIIC1r ✓
- C Hydronephrosis detected on MRI but not on clinical examination
- D Involvement of lower third of vagina detected only on MRI
Explanation
The major revision in FIGO 2018 cervical cancer staging was the incorporation of imaging and pathology findings for lymph node staging. IIIC1 (pelvic lymph node metastasis) and IIIC2 (para-aortic lymph node metastasis) can now be assigned based on imaging findings, designated with suffix 'r' (radiology: IIIC1r, IIIC2r) or 'p' (pathology: IIIC1p, IIIC2p). This is the most significant change from FIGO 2009, which was purely clinical. Parametrial invasion (A) was already detectable clinically for Stage IIB. Hydronephrosis (C) was already Stage IIIB in old classification when detected clinically. Vaginal involvement (D) was already clinical staging in 2009.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.