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Cervical Cancer — SCE Medical Oncology MCQ

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HardGynaecological CancersCervical CancerSCE Medical Oncology

A 34-year-old wishes to preserve fertility. She has HPV-associated squamous cervical cancer measuring 1.6 cm, FIGO 2018 stage IB1, no radiological nodal disease and no high-risk histology. Which curative fertility-sparing procedure may be offered after specialist assessment and nodal staging?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Radical trachelectomy with pelvic sentinel-node or lymph-node assessment

Explanation lettering: D = shown as A · E = shown as B · B = shown as C · C = shown as D · A = shown as E

C is correct. Radical trachelectomy is an established fertility-sparing option for carefully selected, node-negative early cervical cancers generally under 2 cm, with histology, depth, LVSI, margins and nodal findings reviewed by a specialist gynaecological-oncology MDT. Hysterectomy removes fertility, chemotherapy alone is not definitive local treatment, and pelvic chemoradiotherapy causes major ovarian and uterine damage. The original 4.5 cm tumour would now be FIGO IB3 and is not a routine radical-trachelectomy case; reducing the tumour size removes that unsafe implication.

Reference: ESMO gynaecological cancers pocket guideline: https://data.esmo.org/guidelines/pdf/publicassets/ESMO_2023_GynaecologicalCancers.pdf