A 52-year-old woman is found to have cervical cancer with the tumor extending to the lower one-third of the vagina but not to the pelvic side wall, with left hydroureter on IVU. Lymph nodes are clinically negative. According to FIGO 2018 staging (incorporating imaging), what is her correct stage?

• A Stage IIB — parametrial invasion confirmed on MRI
• B Stage IIIA — involvement of lower third of vagina only
• C Stage IVA — bladder involvement implied by hydroureter
• D Stage IIIB — hydroureter without pelvic side wall extension ✓

Explanation

FIGO 2018 cervical cancer staging incorporates imaging (MRI/CT/PET-CT) and assigns Stage IIIB when there is hydroureter or non-functioning kidney caused by the tumor, even if pelvic side wall extension cannot be confirmed clinically. Lower vaginal involvement alone is Stage IIIA. Pelvic side wall extension OR hydronephrosis/hydroureter = Stage IIIB. The FIGO 2018 revision specifically included hydronephrosis as a IIIB criterion regardless of whether pelvic side wall is clinically reached, removing the need for clinical examination of pelvic wall in such cases.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.