Gynaecological oncology: cervical cancer: 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.

Try it

OBG · Gynaecological oncology: cervical cancer

Sample item

A 48-year-old woman has a biopsy-proven squamous carcinoma of the cervix with parametrial extension that stops short of the pelvic side wall, without distant spread. What is the best primary treatment?

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

The answer and the reasoning

D. Concurrent chemoradiotherapy with cisplatin

Locally advanced cervical cancer (stage IIB and above, including parametrial extension) is treated with external beam radiotherapy plus brachytherapy with concurrent cisplatin. Surgery is used for early-stage disease (up to IB2 or IIA1), where radical hysterectomy with pelvic node dissection gives equivalent control. Conisation is for pre-invasive disease or microinvasive disease where fertility is desired.

Option by option

  • A. Simple hysterectomy

    Simple hysterectomy will not clear the parametrial disease.

  • B. Conisation

    Conisation is only for pre-invasive or very early disease.

  • C. Radical hysterectomy with pelvic lymphadenectomy

    Radical hysterectomy is not suitable once the parametria are involved.

  • D. Concurrent chemoradiotherapy with cisplatin (correct)

    Correct. Parametrial spread places her in locally advanced disease, treated by chemoradiation.

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 D, Concurrent chemoradiotherapy with cisplatin. Locally advanced cervical cancer (stage IIB and above, including parametrial extension) is treated with external beam radiotherapy plus brachytherapy with concurrent cisplatin.

Why is "Simple hysterectomy" not the answer?

Simple hysterectomy will not clear the parametrial disease.

Why is "Conisation" not the answer?

Conisation is only for pre-invasive or very early disease.

Why is "Radical hysterectomy with pelvic lymphadenectomy" not the answer?

Radical hysterectomy is not suitable once the parametria are involved.

What concept does this question test?

It tests Gynaecological oncology: cervical cancer in OBG. Surgery is used for early-stage disease (up to IB2 or IIA1), where radical hysterectomy with pelvic node dissection gives equivalent control. Conisation is for pre-invasive disease or microinvasive disease where fertility is desired.

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: cervical cancer?

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.