A 40-year-old woman is diagnosed with cervical carcinoma confined to the cervix, measuring 4.5 cm on MRI with no parametrial or lymph node involvement (FIGO IB3). The recommended primary treatment is:

• A Simple hysterectomy alone
• B Radical hysterectomy (Wertheim's) with pelvic lymph node dissection
• C Neoadjuvant chemotherapy followed by radical hysterectomy
• D Concurrent cisplatin-based chemoradiation ✓

Explanation

For FIGO IB3 cervical carcinoma (tumour >4 cm confined to the cervix, previously called IB2), concurrent cisplatin-based chemoradiation is the preferred primary treatment as it offers equivalent or superior outcomes to surgery with better tolerability and avoids combined treatment morbidity. Radical hysterectomy is an option for IB1/IB2 (≤4 cm) but for IB3, chemoradiation is standard. Neoadjuvant chemotherapy followed by surgery is investigational.

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

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Written and medically reviewed by the StethoPrep medical team.