To study the survival outcomes of uncommon recurrences among patients with cervical cancer compared with loco-regional and nodal recurrences at a tertiary care center in North East India – Bridging the knowledge gap in the existing literature.

Recurrence rates of FIGO stage IB-IIA and IIB-IVA cervical cancer ranges from 11-22% and 28-64% respectively. There is scarcity of data on the pattern of recurrence for unusual sites and its association with survival and prognosis. To study overall survival in patients with distant metastasis compared to local and regional nodal metastasis. A retrospective study was done from 1/1/2017 to 30/12/22. Cervical cancer patients post primary treatments were included. Survival was analyzed with respect to 3 groups local, regional nodal and distant metastasis. 225 patients had recurrences post completion of primary treatment of which 105 (46.6%) had local, 46 (20.4%) had regional nodal and 74 (33.3%) had distant recurrences. Median time for recurrence in local, regional nodal and atypical recurrences were 9, 9 and 13 months (p value - <0.05) respectively. Treatment included systemic chemotherapy 122 (54.2%), metronomic therapy 19 (8.4%), palliative radiotherapy 44 (19.5%), palliative surgery 8 (3.5%) and best supportive care 30 (13.3%) patients. Median Time to treatment-death of patients after recurrence in local, nodal and distant recurrences was 17.0 months, 18.0 months and 10.0 months respectively (p value - < 0.05). Overall Survival of patients after primary treatment with local, nodal and distant recurrences was 35.0 months, 47.0 months and 50.0 months respectively (p value <0.05). Local recurrence is most common followed by regional, nodal and distant recurrences. Overall survival post recurrence was lowest for distant recurrences and highest for local recurrences however overall survival after primary treatment completion was highest for distant recurrence due to the late presentation of distant recurrences.