A 45-year-old woman who underwent radical hysterectomy with bilateral pelvic lymphadenectomy for Stage IB1 squamous cell carcinoma of the cervix 3 years ago presents with a 2 cm ulcerative mass at the vaginal vault. Biopsy confirms recurrent squamous cell carcinoma. PET-CT shows no distant metastases. She received no prior radiotherapy. Which is the most appropriate management?

• A Systemic chemotherapy with cisplatin and paclitaxel alone
• B Concurrent chemoradiation with cisplatin ✓
• C Pelvic exenteration
• D Radical wide local excision of the vault recurrence

Explanation

For isolated central pelvic recurrence in a patient who has not received prior radiotherapy, definitive concurrent chemoradiation with cisplatin is the standard of care and offers curative potential. Pelvic exenteration is reserved for patients who have received prior radiation or have persistent disease after chemoradiation. Systemic chemotherapy alone is palliative, not curative.

Reference: NCCN Guidelines: Cervical Cancer

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.