Yoshihiro Hiramatsu, Eisuke Booka, Hirotoshi Kikuchi, Hiroya Takeuchi
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.
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.