Lymphatic drainage pathways — MCQs

A 44-year-old woman undergoes radical hysterectomy for stage IB2 cervical cancer. During surgery, the gynecologic oncologist notes aberrant lymphatic drainage patterns possibly related to the patient's history of pelvic inflammatory disease and previous cesarean section. Frozen section of a lymph node from the obturator fossa shows metastatic disease. Synthesizing knowledge of primary and collateral cervical lymphatic drainage, which nodal group represents the most critical next level of drainage that would impact surgical decision-making?