A 35-year-old nulliparous woman with FIGO Stage IB1 cervical cancer (squamous, 1.8 cm) wishes to preserve fertility. What is the most appropriate surgical option?
- A Simple trachelectomy
- B LLETZ (large loop excision of the transformation zone)
- C Radical trachelectomy with pelvic lymph node dissection ✓
- D Pelvic exenteration
Correct answer: C. Radical trachelectomy with pelvic lymph node dissection
Explanation
Radical trachelectomy (removal of the cervix, parametrium, and upper vaginal cuff with uterine conservation) combined with pelvic lymphadenectomy is the fertility-sparing surgical standard for early cervical cancer (tumor ≤2 cm, IB1, no lymphovascular space invasion). The isthmus is preserved, allowing future pregnancy with cerclage. Simple trachelectomy does not provide adequate parametrial margins. LLETZ is appropriate only for CIN/microinvasive disease. Pelvic exenteration is for recurrent disease.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.