A 24-year-old woman with newly diagnosed FIGO 2018 Stage IB1 cervical squamous cell carcinoma (2 cm lesion) desires fertility preservation. MRI shows no parametrial extension and negative pelvic nodes. Which surgical procedure is most appropriate for her?
- A Simple extrafascial hysterectomy
- B Radical hysterectomy with bilateral salpingo-oophorectomy
- C Radical trachelectomy with pelvic lymph node dissection ✓
- D Total abdominal hysterectomy with ovarian transposition
Correct answer: C. Radical trachelectomy with pelvic lymph node dissection
Explanation
Radical trachelectomy with pelvic lymph node dissection is the standard fertility-preserving surgical option for Stage IB1 cervical cancer (tumor ≤2 cm, no nodal disease, no parametrial involvement). It removes the cervix and parametria while preserving the uterine corpus. Simple hysterectomy and radical hysterectomy both remove the uterus, eliminating fertility. Stage IA2 is the lower threshold for considering this approach in most guidelines.
Reference: Williams Gynecology, 4th ed.
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Written and medically reviewed by the StethoPrep medical team.