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Sentinel Node Navigation Surgery for Upper Gastrointestinal Malignancies: Current Status, Clinical Significance, and
Yoshihiro Hiramatsu1, Eisuke Booka1, Hirotoshi Kikuchi1
1School of Medicine, Hamamatsu University, Department of Surgery, Hamamatsu, Japan. takeuchi@hama-med.ac.jp.
Aim:
To review the current evidence, technical considerations, clinical significance, and future perspectives of sentinel node navigation surgery (SNNS) for upper gastrointestinal malignancies, focusing on gastric and esophageal cancers.
Methods:
This narrative review summarizes evidence on sentinel node (SN) mapping, biopsy, and SNNS in gastric and esophageal cancers, focusing on feasibility, diagnostic accuracy, indications, and limitations.
Results:
In early gastric cancer, accumulating evidence supports the feasibility and diagnostic accuracy of SN mapping and biopsy, supporting SNNS as a promising platform for function-preserving gastric surgery. In esophageal cancer, clinical application remains challenging because of multidirectional lymphatic drainage and aggressive tumor biology; however, radioisotope-guided SN mapping has shown encouraging results in selected patients with early-stage disease.
Conclusions:
SNNS may reduce surgical invasiveness while preserving oncologic safety and postoperative function in selected patients with upper gastrointestinal malignancies. However, further validation and standardization are required before broader clinical implementation.