Locally advanced-stage cervical carcinoma—Evaluating the options
Bradley J. Monk, MD

A 44-year-old woman, mother of 2 children, presented to her gynecologist due to heavy vaginal discharge and postcoital bleeding in the last 3 months. She has not had a Pap smear in last 5 years since she changed her country of residency.  

  • Pelvic examination: 7-cm barrel shape cervical lesion invading the upper 1/3 of the anterior vaginal wall and infiltrating left parametrium up to 1 cm from the pelvic wall and the medial third of the right parametrium.
  • Pathology: Cervical biopsy confirms invasive squamous carcinoma of the cervix.
  • With additional staging investigation FIGO IIB was determined.
  • Labs: CBC and biochemical profile WNL.
  • History: No comorbid illnesses
  • ECOG Performance status: 0

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Part I
Would you recommend surgical staging including lymphadenectomy (either extraperitoneal or laparoscopic) in this patient with locally advanced cervical cancer?

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Part II
Which of the following would you recommend for initial treatment of this patient?

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