Which group of pelvic lymph nodes is MOST commonly the first site of nodal metastasis from carcinoma of the cervix?

• A Common iliac nodes
• B Para-aortic nodes
• C External iliac nodes distal to the inguinal ligament
• D Obturator and parametrial nodes along the uterine artery ✓

Explanation

Lymphatic drainage of the cervix follows the uterine artery, so metastasis appears first in the paracervical, parametrial and obturator nodes before progressing to external iliac, common iliac and finally para-aortic chains. Para-aortic involvement represents advanced nodal disease and alters radiation fields, while inguinal nodes are not part of the primary drainage pathway. This predictable first-echelon pattern underpins sentinel node mapping in early disease.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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