A 38-year-old woman with cervical cancer stage IB1 (2 cm, confined to cervix) desires fertility preservation. The MOST appropriate fertility-sparing surgical option is:
- A Simple trachelectomy with pelvic lymph node dissection
- B Cone biopsy with close surveillance
- C Radical trachelectomy (Dargent procedure) with pelvic lymph node dissection ✓
- D Pelvic radiation with cervical shielding
Correct answer: C. Radical trachelectomy (Dargent procedure) with pelvic lymph node dissection
Explanation
Radical trachelectomy (Dargent procedure) — removal of the cervix, parametrium, and upper vagina with pelvic lymphadenectomy while preserving the uterine corpus — is the standard fertility-sparing surgery for early-stage cervical cancer (Stage IA2-IB1 with tumor ≤2 cm). It provides oncological outcomes comparable to radical hysterectomy while preserving reproductive potential. Simple trachelectomy does not provide adequate parametrial margins for invasive carcinoma. Cone biopsy alone is inadequate for stage IB1.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.