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Less Extensive Surgery Safe for Women with Early Cervical Cancer

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Less Extensive Surgery Safe for Women with Early Cervical Cancer

A large international study has found that women with early-stage cervical cancer can safely avoid extensive lymph node surgery without increasing their risk of the cancer coming back. The research, known as the SENTIX trial, followed women treated at 47 hospitals in 18 countries and tested whether a smaller, more targeted surgery could replace a traditional, more invasive one.

Normally, doctors remove many lymph nodes in the pelvis — a procedure called pelvic lymphadenectomy (PLND) — to check if the cancer has spread. While effective, this surgery can cause long-term side effects like leg swelling and pain. The sentinel lymph node (SLN) biopsy is a gentler alternative that removes only the first few lymph nodes likely to contain cancer cells.

In this study, 731 women with early-stage cervical cancer underwent SLN biopsy followed by hysterectomy or fertility-preserving surgery. If no cancer was found in the sentinel nodes, doctors did not perform a full lymph node removal.

After two years, the recurrence rate was just 6.1%, nearly identical to what is seen with full lymph node surgery. Survival rates were also excellent — 93% were cancer-free, and 98% were alive two years after treatment.

The study also found that careful lab testing of the sentinel nodes, called ultrastaging, identified small clusters of cancer cells that might otherwise be missed.

These findings show that sentinel lymph node biopsy alone is a safe and effective option for many women with early cervical cancer, offering the same cancer control with fewer side effects and a faster recovery.

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