Gynaecology: Cervix — FIGO 2018 staging
Free question published 05 August 2026
A 46-year-old woman with squamous cell carcinoma of the cervix is staged with examination under anaesthetic and MRI. The cervical tumour measures 3 cm and is confined to the cervix with no parametrial or vaginal involvement. PET-CT identifies an FDG-avid 15 mm left common iliac lymph node but no para-aortic or distant disease. Using the FIGO 2018 classification, which stage should be recorded?
- AStage IB2
- BStage IIB
- CStage IIIC2r
- DStage IIIC1r
- EStage IVB
Why D is correct
Under FIGO 2018, pelvic lymph node metastasis (including common iliac nodes) assigns stage IIIC1 irrespective of tumour size or local extent. Because the node was identified radiologically, the notation 'r' is appended, giving IIIC1r. The revision permits imaging and pathology to supplement clinical findings.
And why the others are not
- AIncorrect. IB2 (tumour 2-4 cm confined to cervix) ignores the nodal disease; nodal involvement upstages to IIIC.
- BIncorrect. IIB requires parametrial invasion, which is absent here.
- CIncorrect. IIIC2 requires para-aortic node involvement, which is not present.
- EIncorrect. IVB denotes distant metastasis; pelvic nodal spread is locoregional and classified as IIIC1.
Source Revised FIGO 2018 staging for carcinoma of the cervix uteri — Bhatla N, et al. Implications of the revised cervical cancer FIGO staging system. Indian Journal of Medical Research, 2021 (reviewing the FIGO 2018 revision, Bhatla et al, Int J Gynecol Obstet 2019).
More free gynaecology questions
2,500+ cited questions like this one are waiting in the vault.
See plans and pricing