What is your preferred surgical management of an endometrial cancer with clinically apparent extension to the cervix?

Given in this scenario with clinically apparent cervical extension and an MRI negative for parametrial involvement, I would want to also ensure the nodes appear normal making the disease consistent with FIGO stage II disease. In this scenario, if the patient does clinically have disease limited to the uterine corpus and cervix, I prefer to start with upfront surgery (assuming she is medically able to undergo surgery). My preference here is to do a laparoscopic approach with nodal assessment, radical hysterectomy, and bilateral salpingo-oophorectomy.

We know from GOG 33 (Creasman et al., PMID 3652025) that of the patients with cervical involvement, almost half also had extrauterine disease (nodal, adnexal, or intraperitoneal). While our imagi...

Assuming no distant disease, would do a simple hysterectomy pelvic and paraaortic lymphadenectomy. The surgical finding would then dictate any further if needed therapy.