Selection of patients
Patients with early-stage cervical cancer were eligible for this prospective study. A total of 356 patients were consecutively enrolled. They underwent SLNB followed by standard treatment, according to institutional guidelines (modified radical hysterectomy/radical hysterectomy plus complete pelvic lymphadenectomy, with or without para-aortic lymph node sampling), during robotic or laparoscopic-assisted surgery between May 2017 and December 2019. The inclusion criteria were as follows: FIGO 2009 stages Ia2–IIa2; squamous cell carcinoma or typical adenocarcinoma (HPV-related); no evidence of bulky or suspicious PLNs, or distant metastases according to conventional imaging studies; surgery as the primary treatment; and the provision of signed informed consent. The exclusion criteria were as follows: age younger than 18 years or older than 70 years; pregnancy; incidence of other tumours within 5 years; contra-indication for surgical treatment; and intra-operative evidence of more advanced disease (>IIa2). Given the learning curve of SLNB, the first 30 patients enrolled were not included in the final statistical analysis13.