{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:39:00Z","timestamp":1787027940470,"version":"build-2736575974"},"reference-count":25,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Radical hysterectomy remains the standard treatment for early-stage cervical cancer. Building on a precise understanding of pelvic anatomy, we previously described a novel nerve-sparing radical hysterectomy technique and classification. This study aims to present the long-term surgical, functional, and oncological outcomes of this approach and to validate its effectiveness in clinical practice. Methods: Between January 2020 and December 2024, consecutive patients with newly diagnosed cervical cancer who underwent nerve-sparing radical hysterectomy using the Muallem technique were prospectively included in the study. The surgical, functional, and oncological outcomes of these patients were assessed and analyzed. Results: Of the 74 eligible patients, 61 met the inclusion criteria. The cohort predominantly presented with advanced \u201cF\u00e9d\u00e9ration Internationale de Gyn\u00e9cologie et d\u2019Obst\u00e9trique (FIGO)\u201d stages (23% IIB, 16% IIIC1r). The median tumor size was 3.9 cm (range: 0.5\u20137.5 cm). The median estimated blood loss was 210 mL, and the median hospital stay was 10 days. Complete recovery of bladder function was observed in all patients within two weeks. Five-year progression-free survival (PFS) and overall survival (OS) rates were 80.6% and 91.9%, respectively. Conclusions: In a cohort enriched with high-risk features, the Muallem nerve-sparing radical hysterectomy was associated with low intraoperative complication rates, minimal blood loss, and excellent functional outcomes. Survival outcomes demonstrated encouraging results, remaining consistent with the upper range of those reported in previously published standard-treatment series. The Muallem classification allowed for tailored surgical radicality without compromising oncological safety.<\/jats:p>","DOI":"10.3390\/diagnostics16050689","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T13:58:03Z","timestamp":1772114283000},"page":"689","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Balancing Radicality and Function: Prospective Long-Term Outcomes of Muallem Nerve-Sparing Radical Hysterectomy Guided by an Anatomy-Oriented Classification"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5029-7365","authenticated-orcid":false,"given":"Andrea","family":"Miranda","sequence":"first","affiliation":[{"name":"Department of Gynecology with Center for Oncological Surgery, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Virchow Campus Clinic, Charit\u00e9 Medical University, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0156-417X","authenticated-orcid":false,"given":"Ahmad","family":"Sayasneh","sequence":"additional","affiliation":[{"name":"Department of Gynecological Oncology, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King\u2019s College London, Westminster Bridge Road, London SE1 7EH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1811-6667","authenticated-orcid":false,"given":"Juri","family":"Amonti","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, University of Brescia, 25136 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5963-6623","authenticated-orcid":false,"given":"Jalid","family":"Sehouli","sequence":"additional","affiliation":[{"name":"Department of Gynecology with Center for Oncological Surgery, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Virchow Campus Clinic, Charit\u00e9 Medical University, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa Zelal","family":"Muallem","sequence":"additional","affiliation":[{"name":"Department of Gynecology with Center for Oncological Surgery, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Virchow Campus Clinic, Charit\u00e9 Medical University, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"ref_1","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. 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