A 28-year-old woman with FIGO 2018 Stage IB1 (less than 2 cm, stromal invasion less than 10 mm, no LVSI) cervical SCC wants to preserve fertility. Which surgical option is most appropriate?

• A Simple trachelectomy alone
• B Conisation with pelvic lymph node dissection
• C Radical hysterectomy is mandatory regardless of fertility desire
• D Radical trachelectomy (abdominal or vaginal) with pelvic lymph node dissection ✓

Explanation

Radical trachelectomy (removal of the cervix with parametria and upper vagina) combined with pelvic lymphadenectomy is the fertility-preserving surgical standard for appropriately selected early-stage cervical cancer (tumour < 2 cm, depth < 10 mm, no LVSI, negative nodes). Simple trachelectomy or conisation alone are not adequate for frankly invasive disease. Radical hysterectomy sacrifices fertility unnecessarily in eligible patients.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.