Cervical Cancer Staging and Management

A 52-year-old postmenopausal woman from Rajasthan presents with vaginal bleeding for 3 months. Cervical examination reveals a friable, bleeding mass. Biopsy confirms squamous cell carcinoma of the cervix. Staging investigations (MRI pelvis and CT chest) show a 4 cm cervical lesion with parametrial invasion but no distant metastases. The tumor does not involve the pelvic sidewall or bladder/rectum. According to FIGO 2009 staging, what is the most likely stage of this malignancy?

A 48-year-old woman with a 15-pack-year smoking history presents with persistent vaginal bleeding and a visible cervical lesion on speculum examination. Cervical biopsy confirms squamous cell carcinoma, stage IB1 (tumour size 2.5 cm, no parametrial involvement). She undergoes radical hysterectomy with pelvic lymphadenectomy. Histopathology reveals tumour invading the outer third of the cervical stroma with 2 out of 15 pelvic lymph nodes involved. According to current FIGO 2009 staging, what is the most appropriate stage for this patient?

A 42-year-old woman with newly diagnosed stage IB cervical cancer (squamous cell carcinoma, 4 cm lesion) is counseled regarding treatment options. She has no distant metastases and normal renal function. What is the drug of choice for concurrent chemoradiation therapy in this patient?

A 38-year-old woman undergoes staging investigations for biopsy-proven cervical cancer. Imaging shows a 3 cm cervical mass with parametrial involvement but no distant metastases. Which is the most common site of metastatic spread in cervical cancer?

A 42-year-old woman from rural Maharashtra presents with post-coital bleeding and vaginal discharge for 3 months. On examination, a 3 cm friable cervical mass is noted. Pap smear shows high-grade squamous intraepithelial lesion (HSIL). What is the most appropriate next step in management?