SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Gynecological Oncology
Sentinel Lymph Node Biopsy Versus Lymphadenectomy in Early-Stage Cervical Cancer: A Meta-Analysis of Oncologic Outcomes and Surgical Morbidity
Chao Xiao 1
Siyuan Zeng 2
Luying Li 2
Ruiqi Wang 2
XUE XIAO 2
1. Zigong First People's Hospital, Zigong, China
2. Sichuan University West China Second University Hospital, Chengdu, China
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Abstract
Objective This study aimed to evaluate the oncologic safety of sentinel lymph node biopsy (SLNB) compared with systematic lymph node dissection (LND) in patients with early-stage cervical cancer and to determine whether SLNB alone yields comparable survival outcomes. Data sources Studies published up to October 2025 were systematically searched in PubMed, Embase, and Web of Science using relevant keywords, including "sentinel lymph node", "cervical cancer", "cervical carcinoma" and "lymphadenectomy." Study eligibility criteria Comparative cohort studies and single-arm studies involving patients with early-stage cervical cancer undergoing SLNB, with or without LND, and reporting survival outcomes— including cancer-specific survival (CSS), disease-specific survival (DSS), overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) —were included. Study appraisal and synthesis methods The quality of the included studies was assessed using appropriate tools: the Cochrane Risk of Bias 2.0 (RoB 2) tool for randomized controlled trials, the Newcastle–Ottawa Scale (NOS) for observational studies, and the Methodological Index for Non-Randomized Studies (MINORS) for single-arm or non-randomized studies. All meta-analyses were performed using the meta package in R. Hazard ratios (HRs) and risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using fixed-or random-effects models depending on heterogeneity. Sensitivity analyses were conducted via leave-one-out analysis. Results The pooled analysis of six comparative studies revealed no significant difference in cancer-specific survival (HR=0.93, 95% CI: 0.27–3.20), overall survival (HR=0.92 (95% CI: 0.65–1.31), disease-free survival (HR=0.99, 95%CI: 0.00–855.48), or progression-free survival (HR= 0.71, 95% CI: 0.29-1.05) between the SLNB and LND groups. SLNB was associated with a significantly lower risk of postoperative complications (RR=0.70, P=0.0406), and did not increase the recurrence rate (RR=0.96, 95% CI: 0.36-2.53) compared with LND. Six single-arm
Summary
Keywords
cervical cancer, Cervical carcinoma, Lymphadenectomy, Meta - analysis, Sentinel lymph node
Received
11 December 2025
Accepted
18 February 2026
Copyright
© 2026 Xiao, Zeng, Li, Wang and XIAO. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Chao Xiao
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