Gynaecological oncology: adjuvant radiotherapy after radical hysterectomy: 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: adjuvant radiotherapy after radical hysterectomy

Sample item

After radical hysterectomy for early-stage cervical cancer, histology shows negative nodes and margins but deep stromal invasion, lymphovascular space invasion and tumour size of 4 cm. What is the usual recommendation?

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

The answer and the reasoning

C. Adjuvant pelvic radiotherapy (Sedlis intermediate-risk criteria)

The Sedlis criteria identify intermediate-risk features after radical hysterectomy, including lymphovascular space invasion, deep stromal invasion and large tumour size, in various combinations, which carry a high risk of pelvic recurrence. Adjuvant pelvic radiotherapy reduces recurrence. Positive nodes, margins or parametria are high risk and need chemoradiation.

Option by option

  • A. No further treatment

    Omitting adjuvant treatment leaves a high recurrence risk.

  • B. Hormone replacement only

    Hormone replacement is not oncological treatment.

  • C. Adjuvant pelvic radiotherapy (Sedlis intermediate-risk criteria) (correct)

    Correct. These intermediate-risk features warrant adjuvant pelvic radiotherapy.

  • D. Repeat surgery

    Repeat surgery does not address microscopic risk.

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.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Adjuvant pelvic radiotherapy (Sedlis intermediate-risk criteria). The Sedlis criteria identify intermediate-risk features after radical hysterectomy, including lymphovascular space invasion, deep stromal invasion and large tumour size, in various combinations, which carry a high risk of pelvic recurrence.

Why is "No further treatment" not the answer?

Omitting adjuvant treatment leaves a high recurrence risk.

Why is "Hormone replacement only" not the answer?

Hormone replacement is not oncological treatment.

Why is "Repeat surgery" not the answer?

Repeat surgery does not address microscopic risk.

What concept does this question test?

It tests Gynaecological oncology: adjuvant radiotherapy after radical hysterectomy in OBG. Adjuvant pelvic radiotherapy reduces recurrence. Positive nodes, margins or parametria are high risk and need chemoradiation.

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: adjuvant radiotherapy after radical hysterectomy?

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.