Gynaecological oncology: radical trachelectomy: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Gynaecological oncology: radical trachelectomy

Sample item

A 28-year-old nulliparous woman has a 1.5 cm squamous carcinoma of the cervix confined to the cervix, with negative pelvic nodes on imaging, and wishes to preserve fertility. Which operation is suitable?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Radical trachelectomy with pelvic lymphadenectomy

Radical trachelectomy removes the cervix, parametria and upper vagina while leaving the uterine body, and is offered for small tumours (usually under 2 cm) without nodal spread in women who desire fertility. Pregnancy is possible but carries risks of preterm birth and cervical stenosis, and delivery is by caesarean section. Nodal assessment is done first.

Option by option

  • A. Radical trachelectomy with pelvic lymphadenectomy (correct)

    Correct. Radical trachelectomy preserves the uterus in small early cervical cancers.

  • B. Wertheim hysterectomy

    A radical hysterectomy removes the uterus and ends fertility.

  • C. Simple hysterectomy

    A simple hysterectomy is inadequate and also ends fertility.

  • D. Chemoradiation with cisplatin

    Chemoradiation is for locally advanced disease and causes ovarian failure.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is A, Radical trachelectomy with pelvic lymphadenectomy. Radical trachelectomy removes the cervix, parametria and upper vagina while leaving the uterine body, and is offered for small tumours (usually under 2 cm) without nodal spread in women who desire fertility.

Why is "Wertheim hysterectomy" not the answer?

A radical hysterectomy removes the uterus and ends fertility.

Why is "Simple hysterectomy" not the answer?

A simple hysterectomy is inadequate and also ends fertility.

Why is "Chemoradiation with cisplatin" not the answer?

Chemoradiation is for locally advanced disease and causes ovarian failure.

What concept does this question test?

It tests Gynaecological oncology: radical trachelectomy in OBG. Pregnancy is possible but carries risks of preterm birth and cervical stenosis, and delivery is by caesarean section. Nodal assessment is done first.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gynaecological oncology: radical trachelectomy?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.