Following radical hysterectomy for early cervical cancer, adjuvant concurrent chemoradiation rather than radiotherapy alone is recommended when which combination of findings is present?

• A Positive pelvic lymph nodes, positive surgical margins, or microscopic parametrial involvement ✓
• B Tumor size greater than 4 cm, deep stromal invasion, lymphovascular space invasion
• C Squamous histology, tumor size greater than 2 cm, age under 40 years
• D Deep stromal invasion alone with negative nodes and margins

Explanation

High-risk factors defined by the Peters criteria, namely positive lymph nodes, involved resection margins, or microscopic parametrial spread, mandate postoperative concurrent cisplatin-based chemoradiation because these confer the highest relapse risk. Option B lists the Sedlis intermediate-risk factors, for which radiotherapy alone is the standard adjuvant. Deep stromal invasion alone with clear nodes and margins does not require chemoradiation.

Reference: Berek and Novak's Gynecology, 16th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.