Gynaecological oncology: pelvic exenteration: 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: pelvic exenteration

Sample item

A woman 18 months after chemoradiation for cervical cancer has a central pelvic recurrence involving the bladder and vagina, with no pelvic side wall involvement or distant metastases on PET-CT. Which surgery offers potential cure?

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

The answer and the reasoning

C. Pelvic exenteration

Pelvic exenteration removes the pelvic organs en bloc, anterior, posterior or total, and is the only curative option for isolated central recurrence after full-dose radiotherapy. Pelvic side wall involvement or distant spread contraindicates it. It requires urinary and faecal diversion and extensive counselling.

Option by option

  • A. Further radiotherapy to the same field

    Repeating full-dose radiotherapy risks severe toxicity and rarely cures.

  • B. Palliative chemotherapy only

    Palliation is for disease unsuitable for surgery.

  • C. Pelvic exenteration (correct)

    Correct. Exenteration is the curative option for central recurrence in a previously irradiated field.

  • D. Simple hysterectomy

    Simple hysterectomy cannot clear a tumour involving the bladder and vagina.

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 C, Pelvic exenteration. Pelvic exenteration removes the pelvic organs en bloc, anterior, posterior or total, and is the only curative option for isolated central recurrence after full-dose radiotherapy.

Why is "Further radiotherapy to the same field" not the answer?

Repeating full-dose radiotherapy risks severe toxicity and rarely cures.

Why is "Palliative chemotherapy only" not the answer?

Palliation is for disease unsuitable for surgery.

Why is "Simple hysterectomy" not the answer?

Simple hysterectomy cannot clear a tumour involving the bladder and vagina.

What concept does this question test?

It tests Gynaecological oncology: pelvic exenteration in OBG. Pelvic side wall involvement or distant spread contraindicates it. It requires urinary and faecal diversion and extensive counselling.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: pelvic exenteration?

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.