FIGO 2018 staging of cervical carcinoma introduced major changes. A patient with a 4.5 cm cervical cancer is found on MRI to have parametrial involvement without sidewall extension and no lymph nodes detected on imaging. However, pelvic lymph node biopsy is positive. What is the correct FIGO 2018 stage?
- A Stage IIB
- B Stage IIIA
- C Stage IIIC1 ✓
- D Stage IVA
Explanation
The most important change in FIGO 2018 cervical cancer staging was the introduction of stage IIIC, which incorporates lymph node involvement regardless of local tumour extent. Stage IIIC1r/p denotes pelvic lymph node metastasis (r = radiologically detected, p = pathologically confirmed), and Stage IIIC2r/p denotes para-aortic node involvement. In this case, parametrial involvement would be stage IIB by local extent, but the positive pelvic lymph node biopsy upstages her to IIIC1p. This change aligned FIGO with TNM staging, recognising that nodal disease is a dominant prognostic factor regardless of primary tumour size.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.