Current Considerations about the Identification of the Sentinel Node in Digestive Tract Cancer

Abstract

Introduction: The pathological sentinel node identified during the surgical treatment of gastrointestinal cancer allows the correct indication of lymphadenectomy, adequate staging and surgical treatment, decreases morbimortality and improves quality of life.

Objective: To present an update on the techniques used for sentinel lymph node detection in gastrointestinal cancer, as well as their role in postoperative staging and adjuvant treatment.

Methods: A comprehensive review was carried out of updated articles on the subject and published in electronic format, including the PubMed, MESH and Cochrane databases. Seventy articles published between 2007 and 2022 were reviewed, of which 40 were selected according to the search keywords, such as ganglio centinela [sentinel node], cáncer gastrointestinal [gastrointestinal cancer] and tratamiento adyuvante [adjuvant treatment].

Development: In gastrointestinal cancer without clinical evidence of local, regional or distant metastasis, the identification of the sentinel lymph node is a determinant factor to perform intraoperative radical lymphadenectomy, as it is the best predictor of lymph node status without invasive surgical techniques.

Conclusions: The usage of sentinel node in the gastrointestinal tract has allowed a change in surgical approach, by means of extending or not the lymphadenectomy to conduct adjuvant treatment or enlargement of the radiation zone according to the histological status of those nodes; it is widely used worldwide and with good outcomes.