A case of carcinoma cervix who earlier received radiotherapy, relapses with new lesion, what should be the next line of management?

ANSWER: (C) Pelvic exenterationREF: Danforth's Obstetrics and Gynecology, 10th Edition P.983Treatment of Recurrent Cervical Cancer:Cervical cancer detected within the first 6 months after primary therapy is often termed persistent cancer, while that diagnosed later is referred to as recurrent disease.Appropriate treatment of recurrent cervical cancer is dictated by both the site of recurrence and the modality of primary therapy.In general, patients in whom locally recurrent disease develops following primary surgery should be considered for salvage radiation therapy.Conversely, surgical treatment should be considered for those patients with recurrent central disease who initially received irradiation.Distantly metastatic recurrent tumor is not amenable to either modality alone and is an indication for palliative chemotherapy and possibly radiation therapy for local control.Pelvic exenteration is usually the procedure of choice for centrally recurrent cervical cancer.