Sentinel Lymph Node Biopsy Noninferior to Lymphadenectomy in Cervical Cancer

WEDNESDAY, Oct. 22, 2025 (HealthDay News) — For patients with early-stage cervical cancer, sentinel lymph node biopsy alone is noninferior to lymphadenectomy with respect to disease-free survival, according to a study published online Oct. 15 in the New England Journal of Medicine.

Hua Tu, M.D., from Sun Yat-sen University Cancer Center in China, and colleagues conducted a multicenter randomized noninferiority trial involving patients with cervical cancer that was stage IA1, IA2, IB1, or IIA1. At the time of surgery, patients underwent sentinel lymph node biopsy; patients who had negative sentinel lymph nodes were assigned intraoperatively not to undergo pelvic lymphadenectomy (the biopsy-only group) or to undergo lymphadenectomy (lymphadenectomy group; 420 and 418 patients, respectively). All patients underwent hysterectomy and received adjuvant therapy.

Patients were followed for a median of 62.8 months. The researchers found that three-year disease-free survival was 94.6 and 96.9 percent in the lymphadenectomy and biopsy-only groups, respectively (difference, –2.3 percentage points; P < 0.001 for noninferiority). Three-year cancer-specific survival was 99.2 and 97.8 percent in the biopsy-only and lymphadenectomy groups, respectively (hazard ratio for death from cancer in competing-risks analysis, 0.37). No patients in the biopsy-only group and nine (2.2 percent) in the lymphadenectomy group had retroperitoneal nodal recurrences. A lower incidence of lymphocyst was seen in the biopsy-only group, and they had a lower incidence of lymphedema, paresthesia, and pain.

“Our findings support the use of sentinel lymph node biopsy as a new standard for surgical management of early-stage cervical cancer,” the authors write.

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