Objectives Recurrent disease in the central pelvis following radiation therapy may potentially be cured with pelvic excenteration (PE) procedure. However, there are other options of treatment according to the characteristics of the patients. The aim of this study is to describe treatments and clinical outcomes in patients with isolated pelvic failures after definitive radiation treatment for cervicalcancer.

Methods Cervical cancer patients with isolated pelvic failure after definitive radiation with brachytherapy (RT) were identified in a tertiary academic center from 2005 to 2014. Isolated failures in the cervix or pelvic nodes were biopsy-proven, and had a compute tomography without distant metastasis.

Results Isolated pelvic failure was detected in 79(7.6) out of 1046 consecutive patients treated RT. The median time to isolated pelvic recurrence was 15 months (range 3–153). Median follow-up time for patients alive after isolated pelvic recurrence was 49 months (range 2–181). of these 79 patients, 19 (24.1%) have PE has elective treatment but only 3 (3.8%) received this procedure, 3 (3.8%) patients had radical hysterectomy (2 patients by original treatment plan and one did not accept PV), 32 (40.5%) was candidate for SC and receive this treatment. 3 patients (3.8%) was candidate palliative care but 13 (16.5%) receive chemotherapy. 24 patients (30.4%) did not receive other treatment, or rejected treatment. Median OS for patients treated with surgery, chemotherapy, or palliative care or not was 20 months (14–145), 9 months (2–12), respectively.

Conclusions Locoregional recurrence could be cured by pelvic excenteration, but most of the patient did not accept the treatment compromising the overall survival.