Staging of ca cervix with parametrial involvement-
Ans. is 'b' i.e., IIB {Ref: Shaw's Gynae 15th/ep. 420 & Internet] Ref- FIGO staging of Cervical carcinomas Stage I Stage I is carcinoma strictly confined to the cervix; extension to the uterine corpus should be disregarded. The diagnosis of both Stages IA1 and IA2 should be based on microscopic examination of removed tissue, preferably a cone, which must include the entire lesion. Stage IA: Invasive cancer identified only microscopically. Invasion is limited to measured stromal invasion with a maximum depth of 5 mm and no wider than 7 mm. Stage IA1: Stage IA1: Measured invasion of the stroma no greater than 3 mm in depth and no wider than 7 mm diameter. Stage IA2: Stage IA2: Measured invasion of stroma greater than 3 mm but no greater than 5 mm in depth and no wider than 7 mm in diameter. Stage IB: Stage IB: Clinical lesions confined to the cervix or preclinical lesions greater than Stage IA. All gross lesions even with superficial invasion are Stage IB cancers. Stage IB1: Stage IB1: Clinical lesions no greater than 4 cm in size. Stage IB2: Stage IB2: Clinical lesions greater than 4 cm in size. Stage II Stage II is carcinoma that extends beyond the cervix, but does not extend into the pelvic wall. The carcinoma involves the vagina, but not as far as the lower third. Stage IIA: No obvious parametrial involvement. Involvement of up to the upper two-thirds of the vagina. Stage IIB: Obvious parametrial involvement, but not into the pelvic sidewall. Stage III Stage III is carcinoma that has extended into the pelvic sidewall. On rectal examination, there is no cancer-free space between the tumour and the pelvic sidewall. The tumour involves the lower third of the vagina. All cases with hydronephrosis or a non-functioning kidney are Stage III cancers. Stage IIIA: No extension into the pelvic sidewall but involvement of the lower third of the vagina. Stage IIIB: Extension into the pelvic sidewall or hydronephrosis or non-functioning kidney. Stage IV Stage IV is carcinoma that has extended beyond the true pelvis or has clinically involved the mucosa of the bladder and/or rectum. Stage IVA: Spread of the tumour into adjacent pelvic organs. Stage IVB: Spread to distant organs. Source: TNM Classification of malignant tumours. L. Sobin and Ch Wittekind (eds.), UICC Internation Union against Cancer, Geneva, Switzerland. pp155-157; 6th ed. 2002
III C
II B
III A
III B