Obstetrics & Gynaecology · Cervical Carcinoma (Risk Factors, Staging, Treatment)

Which statement correctly reflects a change introduced in the FIGO 2018 revision regarding Stage IB tumours confined to the cervix?

  • A The size threshold for IB1 was increased from 2 cm to 5 cm to match endometrial staging
  • B Stage IB was abolished and all macroscopic cervical tumours were reclassified as Stage IIA
  • C Stage IB1 was reduced from lesions up to 4 cm to strictly invasive lesions less than 2 cm
  • D Lymphovascular space invasion became mandatory to classify any tumour as Stage IB
Correct answer: C. Stage IB1 was reduced from lesions up to 4 cm to strictly invasive lesions less than 2 cm

Explanation

FIGO 2018 subdivided the old IB category: IB1 now means lesions smaller than 2 cm, IB2 means 2 cm to less than 4 cm, and IB3 means 4 cm or larger confined to the cervix. This matters therapeutically because the 2 cm cut-off governs eligibility for radical trachelectomy. The old 2009 system had allowed tumours up to 4 cm within IB1, which is precisely what the revision changed.

Reference: Williams Gynecology, 4th ed.

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