Stage IA1 Cervix Cone — SCE Medical Oncology MCQ

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EasyGynaecological CancersStage IA1 Cervix ConeSCE Medical Oncology

A 45-year-old woman with stage IA1 cervical cancer (3 mm depth of invasion, <7 mm width, no LVSI) undergoes cone biopsy with clear margins. She wishes to preserve fertility. Is further treatment needed?

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Correct answer: C — For stage IA1 without LVSI, cone biopsy with clear margins is sufficient treatment — no further surgery or adjuvant therapy is needed; this preserves fertility

Stage IA1 cervical cancer (≤3 mm invasion depth, <7 mm width) without lymphovascular invasion has an extremely low risk of nodal metastasis (<1%) and recurrence (<1%). Cone biopsy (or LLETZ) with negative margins is sufficient curative treatment. No lymph node assessment, radical surgery or adjuvant therapy is needed. This represents the most conservative fertility-preserving approach in cervical cancer. Close follow-up (cytology, colposcopy) is required.

Reference: NICE NG12 Cervical cancer; ESMO 2024 Cervical Cancer; FIGO 2018 staging