A 52-year-old woman treated 3 years ago with concurrent chemoradiation for Stage IIB cervical cancer now has a biopsy-proven solitary 3 cm recurrence confined to the central pelvis. There is no hydronephrosis, no sidewall fixation, and no distant metastasis. What is the most appropriate treatment?
- A Repeat external beam radiotherapy with brachytherapy boost
- B Weekly cisplatin monotherapy
- C Pelvic exenteration ✓
- D Palliative care alone
Correct answer: C. Pelvic exenteration
Explanation
Central pelvic recurrence after prior definitive radiotherapy cannot be re-irradiated safely because tissue tolerance has been exhausted, so pelvic exenteration offers the only realistic chance of cure in selected patients without sidewall, nodal, or distant disease. Repeat radiotherapy risks severe bowel and bladder injury, which kills option A. Systemic chemotherapy is palliative in this setting and is reserved for unresectable or disseminated recurrence.
Reference: Berek and Novak's Gynecology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.