Sentinel node technologies in low-resource settings: Current evidence and future perspectives.

Area of Science:

• Gynecologic Oncology
• Surgical Oncology
• Cancer Staging

Background:

• Sentinel lymph node (SLN) mapping is crucial for accurate staging in gynecologic oncology.
• It offers reduced morbidity compared to traditional systematic lymphadenectomy.

Purpose of the Study:

• To review the role of SLN mapping in gynecologic oncology.
• Emphasis on feasibility, challenges, and future perspectives in low- and middle-income countries (LMICs).

Main Methods:

• A narrative literature review from 2000-2025.
• Included prospective/retrospective trials, reviews, guidelines, and LMIC experiences.
• Searches conducted in PubMed, Scopus, and Web of Science.

Main Results:

• SLN mapping with ultrastaging improves detection of micrometastases (MICs) and isolated tumor cells (ITCs).
• Indocyanine green (ICG) has high detection rates but faces access barriers in LMICs due to cost and equipment needs.
• Alternative tracers (blue dyes, Tc-99m, nanoparticles, SPIO) show variable performance; simplified protocols and training are key for LMIC implementation.

Conclusions:

• SLN mapping is a cornerstone of precision surgical staging in gynecologic oncology.
• Equitable implementation in LMICs hinges on accessible tracers, portable fluorescence, and international collaboration.
• These advancements promote global health equity in cancer care.