Lymphatic spread of carcinoma of the cervix occurs in a predictable stepwise fashion. Which nodal group constitutes the first echelon of drainage from the cervix?
- A Common iliac nodes
- B Parametrial and obturator nodes ✓
- C Para-aortic nodes
- D Inguinal nodes
Correct answer: B. Parametrial and obturator nodes
Explanation
Cervical lymphatics drain first to the paracervical (parametrial), hypogastric and obturator nodes, then sequentially to external and common iliac chains, and finally to para-aortic nodes. Recognising this order explains why sentinel node mapping targets the obturator fossa and why para-aortic involvement defines advanced regional disease requiring extended-field radiotherapy. Inguinal nodes are not part of the cervical drainage pathway, and para-aortic nodes represent a later echelon.
Reference: Berek and Novak's Gynecology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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