After radical hysterectomy for early-stage cervical carcinoma, which combination of findings constitutes the high-risk criteria that mandate adjuvant concurrent chemoradiation irrespective of other factors?

• A Positive pelvic lymph nodes, positive surgical margins, microscopic parametrial involvement ✓
• B Large tumour size, deep stromal invasion, lymphovascular space invasion
• C Squamous histology, age over 50 years, anaemia at surgery
• D Deep stromal invasion, close margin less than 3 mm, capillary-like space involvement

Explanation

Positive nodes, positive margins and parametrial involvement are the high-risk factors identified by the Peters trial, where adding weekly cisplatin to adjuvant radiotherapy improved survival. Option B lists the three Sedlis intermediate-risk factors, which trigger adjuvant radiotherapy based on a nomogram score, not automatic chemoradiation. Option D is a distorted version of the Sedlis triad and is not a recognised standalone criterion set.

Reference: Williams Gynecology, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.